Burns ; complications ; Humans ; Hypoxia ; Ischemia ; Shock ; etiology

Acute respiratory distress syndrome (ARDS) is a clinical syndrome defined by acute onset of hypoxemia and bilateral pulmonary opacities not fully explained by cardiac failure or volume overload. At present, there is no specific drug treatment for ARDS, and the mortality rate is high. The reason may be that ARDS has rapid onset, rapid progression, complex etiology, and great heterogeneity of clinical manifestations and treatment. Compared with traditional data analysis, machine learning algorithms can automatically analyze and obtain rules from complex data and interpret them to assist clinical decision making. This review aims to provide a brief overview of the machine learning progression in ARDS clinical phenotype, onset prediction, prognosis stratification, and interpretable machine learning in recent years, in order to provide reference for clinical.
Humans ; Hypoxia/complications* ; Respiratory Distress Syndrome/etiology* ; Prognosis ; Machine Learning

Animals ; Humans ; Hypertension, Pulmonary ; complications ; Hypothermia ; complications ; Hypoxia ; etiology ; therapy ; Respiratory Distress Syndrome, Adult ; complications ; Shock, Septic ; complications

OBJECTIVETo investigate the risk factors for capillary leak syndrome (CLS) in children with malignant hematologic diseases.

METHODSThirty children with hematological malignancies complicated with CLS were analyzed with multiple logistic regression analysis.

RESULTSAt the test level of 0.05, hypoxemia and septicemia were found to significantly correlate with CLS in these children, and the number of white blood cells before CLS and severe bone marrow suppression were near the test level.

CONCLUSIONHypoxemia and septicemia are risk factors for CLS in children with malignant hematologic diseases.

Capillary Leak Syndrome ; complications ; Child ; Hematologic Neoplasms ; complications ; Humans ; Hypoxia ; complications ; Leukocyte Count ; Risk Factors ; Sepsis ; complications

Objective To investigate the characteristics of nocturnal intermittent hypoxemia in patients with heart failure(HF) with preserved ejection fraction(HFpEF).Methods Patients(n=854) who completed sleep test and echocardiography from January 2011 to December 2014 were retrospectively studied. HF patients with an ejection fraction(EF) of ≥50% were included in the HFpEF group(n=112) while HF patients with an EF of <50% included in the group of HF patients with reduced EF(HFrEF)(n=104). Respiratory events and minimum nocturnal saturation(minSaO) were recorded by home sleep testing,and the percentage of total sleep time with saturation <90%(T90SaO) were calculated.Results Compared with patients without HF,subjects with HFpEF and HFrEF had more breathing events[13(5,29)/h vs. 18(6,36)/h,and 21(8,45)/h,P<0.001],lower minSaO[85(80,87)% vs. 82(77,86)% and 83(78,87)%,P<0.001] and relatively longer T90SaO[3.0(0.4,15.5)% vs. 6.0(1.5,24.8)% and 6.7(1.3,14.4)%,P<0.001]. The HFpEF group had significantly higher odds of moderate-severe hypoxemia(minSaO<85%) during sleep than those without HF(OR=2.02,95%CI=1.34-3.11,P<0.001),with the significance persisting after adjusting for covariates including age,gender,hypertension,diabetes,coronary heart disease,renal dysfunction,and smoking(OR=1.85,95%CI=1.20-2.90,P=0.006).Conclusion Patients with HFpEF have frequent nocturnal intermittent hypoxemia,which warrants further investigations to evaluate if remission of night-time hypoxemia may improve long-term prognosis in this cohort.
Echocardiography ; Heart Failure ; complications ; Humans ; Hypoxia ; complications ; Oxygen ; blood ; Polysomnography ; Prognosis ; Retrospective Studies ; Sleep ; Stroke Volume

Obstructive sleep apnea syndrome (OSAS), a prevalent sleep disorder in children, is characterized by recurring upper airway obstruction during sleep. OSAS in children can cause intermittent hypoxia and sleep fragmentation, ultimately affect brain development and further lead to cognitive impairment if lack of timely effective intervention. In recent years, magnetic resonance imaging (MRI) and electroencephalogram (EEG) have been employed to investigate brain structure and function abnormalities in children with OSAS. Previous studies have indicated that children with OSAS showed extensive gray and white matter damage, abnormal brain function in regions such as the frontal lobe and hippocampus, as well as a significant decline in general cognitive function and executive function. However, the existing studies mainly focused on the regional activity, and the mechanism of pediatric OSAS affecting brain networks remains unknown. Moreover, it's unclear whether the alterations in brain structure and function are associated with their cognitive impairment. In this review article, we proposed two future research directions: 1) future studies should utilize the multimodal neuroimaging techniques to reveal the alterations of brain networks organization underlying pediatric OSAS; 2) further investigation is necessary to explore the relationship between brain network alteration and cognitive dysfunction in children with OSAS. With these efforts, it will be promising to identify the neuroimaging biomarkers for monitoring the brain development of children with OSAS as well as aiding its clinical diagnosis, and ultimately develop more effective strategies for intervention, diagnosis, and treatment.
Humans ; Child ; Sleep Apnea, Obstructive/complications* ; Cognition ; Hypoxia/complications* ; Hippocampus ; Frontal Lobe

Diffuse malignant mesothelioma is a rare malignant tumor having poor prognosis. There is still no widely acceptable staging system of the disease and pathologic diagnosis is difficult. Although surgical treatment for diffuse malignant mesothelioma has been controversial, extrapleural peumonectomy in selected patients could prolong the survival when it was combined with adjuvant chemotherapy and radiation therapy. We experienced 4 cases of diffuse malignant mesothelioma for 7 years since 1992, they were treated with extrapleural pneumonectomy without early postoperative mortality. Three patients underwent adjuvant therapy after surgery; chemotherapy in two, and chemo-radiation therapy in one, but one patient could not receive adjuvant therapy because of postoperative complication of hypoxic brain damage due to cardiac torsion and empyema. In this article, we describe surgical experience of extrapleural pneumonectomy and discuss about the controversial points of the disease.
Chemotherapy, Adjuvant ; Diagnosis ; Drug Therapy ; Empyema ; Humans ; Hypoxia, Brain ; Mesothelioma* ; Mortality ; Pneumonectomy* ; Postoperative Complications ; Prognosis

OBJECTIVETo explore the value of electroencephalogram (EEG) in early diagnosis of brain injury in neonates with asphyxia.

METHODSEEG examination was performed in 49 neonates with asphyxia (mild: n=9; severe: n=40) within 6 hrs of their births. Of the 49 asphyxiated neonates, 33 had concurrent HIE, including 20 cases of mild, 9 cases of moderate and 4 cases of severe HIE.

RESULTSTwenty-one (63.6%) out of the 33 patients with HIE showed abnormal EEG, but only one (6.3%) in the asphyxia group without HIE. All of 13 patients with moderate-severe HIE showed abnormal EEG. The degree of EEG abnormality in neonates with HIE was consistent with the clinical grading of HIE. The neonates whose EEG showed electrical silence and burst suppression and the abnormalities were kept unrecoverable for more than 2 weeks had very poor prognosis.

CONCLUSIONSEEG can reflect brain injury caused by neonatal asphyxia and the severity of brain injury. It may be useful for early diagnosis of brain injury following asphyxia in neonates.

Asphyxia Neonatorum ; complications ; physiopathology ; Early Diagnosis ; Electroencephalography ; Female ; Humans ; Hypoxia-Ischemia, Brain ; diagnosis ; Infant, Newborn ; Male

Chronic obstructive pulmonary disease (COPD) is a pulmonary as well as a systemic disease. Erectile dysfunction (ED) is one of the extrapulmonary manifestations of COPD, and its incidence increases with the aggravation of COPD. The mechanisms of ED in patients with COPD are not yet completely understood. Insights into the incidence and related factors of COPD-associated ED may contribute to its early diagnosis, prevention and development, and it also helps to improve the quality of life of COPD patients.
Erectile Dysfunction ; etiology ; Humans ; Hypoxia ; Male ; Oxidative Stress ; Pulmonary Disease, Chronic Obstructive ; complications ; Smoking

A series of studies demonstrated that myocardial damage and cardiac dysfunction occur immediately after severe burn even before the intervention of significant reduction in blood volume as a result of increased capillary permeability. Because the heart is the power organ of the circulation, such myocardial damage and cardiac dysfunction lead not only to cardiac deficiency, it is also a precipitating factor of burn shock and ischemic/hypoxic injury. Therefore, we nominate this phenomenon as "shock heart". New measures including "volume replacement" plus "dynamic support" proposed according to this new recognition is of important clinical significance for burn shock resuscitation and prevention and treatment of ischemic/hypoxic injury, as well as reducing organ complications resulting from insufficient or excessive fluid resuscitation during early postburn stage.
Burns ; complications ; Humans ; Hypoxia ; etiology ; Myocardial Reperfusion Injury ; etiology ; Shock ; etiology