Objective:To evaluate the application value of electrical impedance tomography(EIT)imaging combining bedside bronchoscopy sputum suction by observing the changes of pulmonary ventilation, tidal volume and dynamic pulmonary compliance after bedside bronchoscopy sputum suction in elderly stroke-associated pneumonia(SAP).Methods:A randomized controlled study was conducted.Patients with SAP admitted to the respiratory intensive care unit of Henan Provincial People's Hospital from January 2017 to December 2018 were enrolled as research objects.They were divided into the control group versus observation group with the only difference in receiving bedside bronchoscope sputum suction replacing control's receiving conventional sputum suction.Impedance imaging region of interest 4(ROI4)values collected by using EIT at admission and 1, 3, 5 days after fiberoptic bronchoscope sputum suction were compared between the two groups.Meanwhile, the tidal volume, dynamic lung compliance, the duration of mechanical ventilation and hospitalization time in intensive care unit were recorded in the two groups.Results:A total of 78 patients meeting an inclusion and exclusion criterion were enrolled, with 37 cases in the control group and 41 cases in the observation group.Compared with control group, the bronchoscope sputum suction group showed the significantly increased regional gas distribution values(2.24±0.77% vs.0.49±0.65%, 7.05±0.77% vs.2.49±0.87%, 12.34±1.47% vs.5.57±0.50%, t=10.85, 24.56 and 26.54, respectively, all P<0.001)at 1, 3, 5 days after fiberoptic bronchoscope sputum suction.The tidal volume and dynamic lung compliance were significantly higher in the observation group than in the control group at 1, 3, 5 days after fiberoptic bronchoscope sputum suction.The duration of mechanical ventilation and hospitalization time in the intensive care unit were shorter in the observation group than in the control group(12.22±0.88 d vs.14.65±0.92 d, 18.41±1.12 d vs.21.14±1.06 d, t=11.91 and 11.01, both P< 0.001). Conclusions:For patients with SAP, an intermittent bedside fiberoptic bronchoscope sputum suction can effectively improve the pulmonary ventilation in the dorsal area, optimize pulmonary respiratory dynamics, facilitate the early withdrawal of the mechanic ventilation, and shorten the hospitalization time in the intensive care unit.

OBJECTIVETo improve the diagnostic accuracy of fetal pulmonary venous abnormalities through the analysis of the fetal pulmonary vein anatomy.

METHODS234 cases of congenital cardiac abnormalities were detected by echocardiography during pregnancy in An Zhen Hospital, Capital Medical University from May 2010 to August 2015. Autopsy was then performed. The type of fetal pulmonary venous malformation, cardiac abnormalities, systemic venous malformations, and other internal organs deformities were documented.

RESULTSThere were ninteen cases of pulmonary venous malformations among the 234 cases of fetal congenital heart disease. These included two cases of congenital pulmonary venous hypoplasia (CPVH) or atresia, four cases of partial anomalous pulmonary venous drainage (PAPVD), seven cases of total anomalous pulmonary venous drainage (TAPVD), five cases of atresia of common pulmonary vein (CPV), one case of congenital pulmonary venous hypoplasia with total anomalous pulmonary venous drainage. There were eleven cases with single ventricle, eight cases with right aortic arch, seven cases with single atrium and six cases with pulmonary valve stenosis. Eleven cases had pulmonary hypoplasia and nine cases had abnormal spleen.

CONCLUSIONSThere are many variations in pulmonary venous abnormalities associated with severe and complex cardiac abnormalities and internal organs malformation. Care should be exercised during autopsy examination to look for all branches of the pulmonary vein.

Autopsy ; Female ; Fetal Diseases ; Heart Defects, Congenital ; diagnosis ; Humans ; Pregnancy ; Pulmonary Veins ; abnormalities ; Spleen ; pathology