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| 1 | Efficacy of prone position in acute respiratory distress syndrome patients: A pathophysiology-based review显示文摘Acute respiratory distress syndrome(ARDS) is a syndrome with heterogeneous underlying pathological processes. It represents a common clinical problem in intensive care unit patients and it is characterized by high mortality. The mainstay of treatment for ARDS is lung protective ventilation with low tidal volumes and positive end-expiratory pressure sufficient for alveolar recruitment. Prone positioning is a supplementary strategy available in managing patients with ARDS. It was first described 40 years ago and it proves to be in alignment with two major ARDS pathophysiological lung models; the 'sponge lung'- and the 'shape matching'-model. Current evidence strongly supports that prone positioning has beneficial effects on gas exchange, respiratory mechanics, lung protection and hemodynamics as it redistributes transpulmonary pressure, stress and strain throughout the lung and unloads the right ventricle. The factors that individually influence the time course of alveolar recruitment and the improvement in oxygenation during prone positioning have not been well characterized. Although patients' response to prone positioning is quite variable and hard to predict, large randomized trials and recent meta-analyses show that prone position in conjunction with a lung-protective strategy, when performed early and in sufficient duration, may improve survival in patients with ARDS. This pathophysiology-based review and recent clinical evidence strongly support the use of prone positioning in the early management of severe ARDS systematically and not as a rescue maneuver or a last-ditch effort. | Vasilios Koulouras Georgios Papathanakos Athanasios Papathanasiou Georgios Nakos | 2016 | World Journal of Critical Care Medicine2016，5，2： | 39 |
| 2 | 俯卧位通气对急性呼吸窘迫综合征患者预后影响的荟萃分析显示文摘目的:系统评价俯卧位通气(PPV)对急性呼吸窘迫综合征(ARDS)患者预后的影响。方法检索美国国家医学图书馆PubMed数据库、WebofScience、Cochrane系统评价和临床试验数据库、生物医学与药理学文摘数据库(EMBASE)、中国生物医学文献数据库(CBM)和中国期刊网全文数据库(CNKI)等数据库,系统收集相关随机对照临床试验(RCT)文献。按Cochrane系统评价方法筛选试验、评价质量、提取资料,采用RevMan5.1软件进行Meta分析。结果最终纳入10项临床对照试验,共2187例患者,全部为随机对照试验,研究质量为B或C。荟萃分析结果显示,与对照组比较,PPV可明显提高ARDS患者氧合指数(6h氧合指数比较:MD=28.19,95%CI为12.39~43.98,P=0.0005;4d氧合指数比较:MD=22.34,95%CI为10.77~33.91,P=0.0002;10d氧合指数比较:MD=18.07,95%CI为3.50~32.64,P=0.02)。与对照组比较,PPV能够降低总体死亡率(OR=0.75,95%CI为0.59~0.96,P=0.02),但ICU死亡率(OR=0.74,95%CI为0.51~1.05,P=0.09)、28d死亡率(OR=0.75,95%CI为0.44~1.29,P=0.30)、90d死亡率(OR=0.69,95%CI为0.30~1.60,P=0.39)及6个月死亡率(OR=0.88,95%CI为0.62~1.26,P=0.49)两组比较差异均无统计学意义。PPV组住ICU天数与对照组比较差异有统计学意义(MD=1.43,95%CI为0.38~2.48,P=0.007),而机械通气天数(受访90d)两组比较差异无统计学意义(MD=-0.42,95%CI为-1.56~0.72,P=0.47)。PPV组呼吸机相关肺炎发生率与对照组比较差异无统计学意义(OR=0.83,95%CI为0.62~1.13,P=0.24),压疮发生率PPV组高于对照组(OR=1.36,95%CI为1.06~1.74,P=0.01),意外拔管发生率两组比较差异无统计学意义(OR=0.94,95%CI为0.62~1.42,P=0.75),气胸发生率两组比较差异无统计学意义(OR=0.75,95%CI为0.45~1.25,P=0.27)。结论应用PPV治疗ARDS患者能明显提高氧合指数,降低总死亡率,尤其对于重度ARDS患者,可明显改善预后。 | 范平 石俊 陆杉 姚智渊 袁亮 朱曦 | 2014 | 中国急救医学2014，34，4： | 23 |
| 3 | 俯卧位通气在中重度急性呼吸窘迫综合征的临床应用进展显示文摘1976年Douglas等首先观察到俯卧位通气(prone position ventilation,PPV)可以改善急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)患者的氧饱和度,迄今为止已有近40年的历史,随着科学研究的进步和临床技术水平的提高,PPV在临床救治ARDS尤其是中重度ARDS的过程中应用越来越广泛,目前已经公认作为严重ARDS的挽救性治疗手段。本文重点就PPV救治中重度ARDS的机制和应用过程中所存在的主要问题综述如下。 | 刘兆润 董丽 吴国刚 | 2016 | 中国呼吸与危重监护杂志2016，15，5： | 22 |
| 4 | Brain-lung crosstalk: Implications for neurocritical care patients显示文摘Major pulmonary disorders may occur after brain injuries as ventilator-associated pneumonia, acute respiratory distress syndrome or neurogenic pulmonary edema. They are key points for the management of brain-injured patients because respiratory failure and mechanical ventilation seem to be a risk factor for increased mortality, poor neurological outcome and longer intensive care unit or hospital length of stay. Brain and lung strongly interact via complex pathways from the brain to the lung but also from the lung to the brain. Several hypotheses have been proposed with a particular interest for the recently described 'double hit' model. Ventilator setting in brain-injured patients with lung injuries has been poorly studied and intensivists are often fearful to use some parts of protective ventilation in patients with brain injury. This review aims to describe the epidemiology and pathophysiology of lung injuries in brain-injured patients, but also the impact of different modalities of mechanical ventilation on the brain in the context of acute brain injury. | Ségolène Mrozek Jean-Michel Constantin Thomas Geeraerts | 2015 | World Journal of Critical Care Medicine2015，4，3： | 20 |
| 5 | 针对性护理在预防重症患者呼吸机相关性肺炎中的运用显示文摘呼吸机相关性肺炎(ventilator associated pneumonia,VAP)是行机械通气(mechanical ventilation,MV)48h以后患者肺部发生的感染,其在重症患者中比较常见,发生率可高达45%以上,且救治较困难,不仅会使重症患者临床病情加重,住院时间增加,而且可能会危及到生命安全。有研究指出[1],重视临床护理是预防重症患者VAP的关键。 | 武海燕 郝青 张秀敏 吕素芳 李泽民 王娟 孙晓娟 刘延静 | 2016 | 山西医药杂志2016，45，13： | 20 |
| 6 | Otitis media with effusion in children: Pathophysiology, diagnosis, and treatment.A review显示文摘Otitis media with effusion(OME)is a frequent paediatric disorder.The condition is often asymptomatic,and so can easily be missed.However,OME can lead to hearing loss that impairs the child's language and behavioural development.The diagnosis is essentially clinical,and is based on otoscopy and(in some cases)tympanometry.Nasal endoscopy is only indicated in cases of unilateral OME or when obstructive adenoid hypertrophy is suspected.Otitis media with effusion is defined as the observation of middle-ear effusion at consultations three months apart.Hearing must be evaluated(using an age-appropriate audiometry technique)before and after treatment,so as not to miss another underlying cause of deafness(e.g.perception deafness).Craniofacial dysmorphism,respiratory allergy and gastro-oesophageal reflux all favour the development of OME.Although a certain number of medications(antibiotics,corticoids,antihistamines,mucokinetic agents,and nasal decongestants)can be used to treat OME,they are not reliably effective and rarely provide long-term relief.The benchmark treatment for OME is placement of tympanostomy tubes(TTs)and(in some cases)adjunct adenoidectomy.The TTs rapidly normalize hearing and effectively prevent the development of cholesteatoma in the middle ear.In contrast,TTs do not prevent progression towards tympanic atrophy or a retraction pocket.Adenoidectomy enhances the effectiveness of TTs.In children with adenoid hypertrophy,adenoidectomy is indicated before the age of 4 but can be performed later when OME is identified by nasal endoscopy.Children must be followed up until OME has disappeared completely,so that any complications are not missed. | Pauline Vanneste Cyril Page | 2019 | Journal of Otology2019，14，2： | 19 |
| 7 | 慢重症新诊断标准及治疗进展显示文摘1概述
1.1慢重症概念的提出
1985年,美国Girard等[1]发现ICU中的部分患者渡过疾病的急性期后,需要长时间生命支持和护理,主要表现为机械通气时间延长(prolonged mechanical ventilation,PMV)。这部分患者脱机困难,预后极差,医疗花费巨大,他们将这类患者归纳为"慢重症"(chronically critical ill,CCI)患者,PMV则成为了CCI患者最明显的标志。CCI的概念提出之后立刻得到广泛关注, | 杨娜 李维勤 | 2016 | 中华危重症医学杂志(电子版)2016，9，3： | 18 |
| 8 | Risk factors for ventilator-associated pneumonia in trauma patients:A descriptive analysis显示文摘BACKGROUND:We sought to evaluate the risk factors for developing ventilator-associated pneumonia(VAP)and whether the location of intubation posed a risk in trauma patients.METHODS:Data were retrospectively reviewed for adult trauma patients requiring intubation for>48 hours,admitted between 2010 and 2013.Patients’demographics,clinical presentations and outcomes were compared according to intubation location(prehospital intubation[PHI]vs.trauma room[TRI])and presence vs.absence of VAP.Multivariate regression analysis was performed to identify predictors of VAP.RESULTS:Of 471 intubated patients,332 patients met the inclusion criteria(124 had PHI and208 had TRI)with a mean age of 30.7±14.8 years.PHI group had lower GCS(P=0.001),respiratory rate(P=0.001),and higher frequency of head(P=0.02)and chest injuries(P=0.04).The rate of VAP in PHI group was comparable to the TRI group(P=0.60).Patients who developed VAP were 6 years older,had significantly lower GCS and higher ISS,head AIS,and higher rates of polytrauma.The overall mortality was 7.5%,and was not associated with intubation location or pneumonia rates.In the early-VAP group,gram-positive pathogens were more common,while gram-negative microorganisms were more frequently encountered in the late VAP group.Logistic regression analysis and modeling showed that the impact of the location of intubation in predicting the risk of VAP appeared only when chest injury was included in the models.CONCLUSION:In trauma,the risk of developing VAP is multifactorial.However,the location of intubation and presence of chest injury could play an important role. | Suresh Kumar Arumugam Insolvisagan Mudali Gustav Strandvik Ayman El-Menyar Ammar Al-Hassani Hassan Al-Thani1 | 2018 | World Journal of Emergency Medicine2018，9，3： | 17 |
| 9 | Ground-temperature controlling effects of duct-ventilated railway embankment in permafrost regions显示文摘Based on observed data from field-testing embankment of the Qinghai-Tibet Railway, ground-temperature controlling effect of duct-ventilated embankment is studied in this paper.The results show that ventilation ducts can effectively cool the soils surrounding the ducts of the embankment, and the heat budget of the ambient soils in a year shows as heat release. Temperature status of the permafrost below the embankment with ducts buried in the relatively high position is similar to that of the common embankment. The permafrost processes warming all along in the two freezing-thawing cycles when the embankment was constructed. However, the temperature of the frozen soils below the embankment, in which the ducts buried in the relatively low position, rises a little in the initial stage. After that, it cools down gradually. At the same time,ventilation ducts can effectively reduce the thermal disturbance caused by the filled soils. The frozen soils below the common embankment and that with high-posited ducts absorb heat all along in the initial two cycles. While the soils below the embankment with low-posited ducts begin to release heat in the second cycle. This phenomenon proves that the ventilation embankment with low-posited ducts shows efficient temperature-controlling effect. Such embankment can actively cool the subgrade soils and therefore keeps the roadbed thermally stable. | NIU Fujun CHENG Guodong YU Qihao | 2004 | Science China Earth Sciences2004，47，z1： | 16 |
| 10 | EXPERIMENTAL RESEARCH ON A SUPERCAVITATING SLENDER BODY OF REVOLUTION WITH VENTILATION显示文摘The behavior of supercavitating and cavitating flow around a conical body of revolution with and without ventilation at several angles of attack was studied experimentally. The hydrodynamical forces for a range of cavitation number were measured. Comparisons of the appearance and the hydrodynamical forces in condition of cavity with and without ventilation were made over the same range of the cavitation number, and a well agreement was obtained. The changes of the drag were especially studied. The experimental results showed that the drag of the model decreased with the presence of supercavity under the ventilation condition. | Feng, Xue-Mei Lu, Chuan-Jing Hu, Tian-Qun | 2002 | Journal of Hydrodynamics2002，14，2： | 15 |
| 11 | 无创正压通气技术在急诊的应用显示文摘前言无创通气的历史是一部关于无创负压和正压通气模式发展的交织编年史,因在历史的不同时期,每种模式都曾经占过主导地位。例如,20世纪80年代中期,所有使用呼吸支持的患者都接受过胸部铁肺负压通气治疗,然而现如今绝大多数都在使用无创正压通气(non-invasive positive pressure ventilation,NIPPV)模式,世界上成千上万的睡眠呼吸暂停综合征的患者正接受持续NIPPV治疗。 | 赵斌 刘肖 | 2016 | 中国医刊2016，51，9： | 13 |
| 12 | 清除气囊上滞留物对预防呼吸机相关性肺炎的研究进展显示文摘呼吸机相关性肺炎(ventilator-associated pneumonia,VAP)是指气管插管或气管切开患者在接受机械通气(Mechanical ventilation,MV)48 h后发生的肺炎,是重症医学科内患者最常见的院内获得性感染之一。因此,有效预防VAP已成为重症患者救治的重要内容。本文就清除气囊上滞留物对预防VAP的研究进展综述如下。 | 刘芬莲 戴丽丽 | 2016 | 护理实践与研究2016，13，5： | 10 |
| 13 | Iatrogenic pneumothorax related to mechanical ventilation显示文摘Pneumothorax is a potentially lethal complication associated with mechanical ventilation. Most of the patients with pneumothorax from mechanical ventilation have underlying lung diseases; pneumothorax is rare in intubated patients with normal lungs. Tension pneumothorax is more common in ventilated patients with prompt recognition and treatment of pneumothorax being important to minimize morbidity and mortality. Underlying lung diseases are associated with ventilatorrelated pneumothorax with pneumothoraces occurring most commonly during the early phase of mechanical ventilation. The diagnosis of pneumothorax in critical illness is established from the patients' history, physical examination and radiological investigation, although the appearances of a pneumothorax on a supine radiograph may be different from the classic appearance on an erect radiograph. For this reason, ultrasonography is beneficial for excluding the diagnosis of pneumothorax. Respiration-dependent movement of the visceral pleura and lung surface with respect to the parietal pleura and chest wall can be easily visualized with transthoracic sonography given that the presence of air in the pleural space prevents sonographic visualization of visceral pleura movements. Mechanically ventilated patients with a pneumothorax require tube thoracostomy placement because of the high risk of tension pneumothorax. Small-bore catheters are now preferred in the majority of ventilated patients. Furthermore, if there are clinical signs of a tension pneumothorax, emergency needle decompression followed by tube thoracostomy is widely advocated. Patients with pneumothorax related to mechanical ventilation who have tension pneumothorax, a higher acute physiology and chronic health evaluation Ⅱ score or Pa O2/Fi O2 < 200 mm Hg were found to have higher mortality. | Chien-Wei Hsu Shu-Fen Sun | 2014 | World Journal of Critical Care Medicine2014，3，1： | 10 |
| 14 | Numerical and Experimental Study on Ventilation Panel Models in a Subway Passenger Compartment显示文摘The internal flow field study of car compartments is an important step in railroad vehicle design and optimization. The flow field profile has a significant impact on the temperature distribution and passenger comfort level. Experimental studies on flow field can yield accurate results but carry a high time and computational cost. In contrast, the numerical simulation method can yield an internal flow field profile in less time than an experimental study. This study aims to improve the computational efficiency of numerical simulation by adapting two simplified models—the porous media model and the porous jump face model—to study the internal flow field of a railroad car compartment. The results provided by both simplified models are compared with the original numerical simulation model and with experimental data. Based on the results, the porous media model has a better agreement with the original model and with the experimental results. The flow field parameters (temperature and velocity) of the porous media model have relatively small numerical errors, with a maximum numerical error of 4.7%. The difference between the numerical results of the original model and those of the porous media model is less than 1%. By replacing the original numerical simulation model with the porous media model, the flow field of subway car compartments can be calculated with a reduction of about 25% in computing resources, while maintaining good accuracy. | Yu Tao Mingzhi Yang Bosen Qian Fan Wu Tiantian Wang | 2019 | Engineering2019，5，2： | 9 |
| 15 | 早产儿经鼻间歇正压通气的专家共识显示文摘经鼻间歇正压通气(nasal intermittent positive pressure ventilation,NIPPV)是在经鼻持续气道正压通气(nasal continuous positive airway pressure,n CPAP)的基础上给予间歇正压的一种呼吸支持模式,由于其具有避免气管插管等无创呼吸支持的优点,在早产儿领域的应用越来越多,已经成为早产儿的重要辅助通气方式[1,2]。 | 史源 汪丽 无 | 2016 | 发育医学电子杂志2016，4，2： | 9 |
| 16 | Preemptive mechanical ventilation can block progressive acute lung injury显示文摘Mortality from acute respiratory distress syndrome(ARDS) remains unacceptable, approaching 45% in certain high-risk patient populations. Treating fulminant ARDS is currently relegated to supportive care measures only. Thus, the best treatment for ARDS may lie with preventing this syndrome from ever occurring. Clinical studies were examined to determine why ARDS has remained resistant to treatment over the past several decades. In addition, both basic science and clinical studies were examined to determine the impact that early, protective mechanical ventilation may have on preventing the development of ARDS in at-risk patients. Fulminant ARDS is highly resistant to both pharmacologic treatment and methods of mechanical ventilation. However, ARDS is a progressive disease with an early treatment window that can be exploited. In particular, protective mechanical ventilation initiated before the onset of lung injury can prevent the progression to ARDS. Airway pressure release ventilation(APRV) is a novel mechanical ventilation strategy for delivering a protective breath that has been shown to block progressive acute lung injury(ALI) and prevent ALI from progressing to ARDS. ARDS mortality currently remains as high as 45% in some studies. As ARDS is a progressive disease, the key to treatment lies with preventing the disease from ever occurring while it remains subclinical. Early protective mechanical ventilation with APRV appears to offer substantial benefit in this regard and may be the prophylactic treatment of choice for preventing ARDS. | Benjamin Sadowitz Sumeet Jain Michaela Kollisch-Singule Joshua Satalin Penny Andrews Nader Habashi Louis A Gatto Gary Nieman | 2016 | World Journal of Critical Care Medicine2016，5，1： | 9 |
| 17 | Ventilator management for acute respiratory distress syndrome associated with avian infl uenza A(H7N9) virus infection: A case series显示文摘BACKGROUND: Data on the mechanical ventilation(MV) characteristics and radiologic features for the cases with H7 N9-induced ARDS were still lacking.METHODS: We describe the MV characteristics and radiologic features of adult patients with ARDS due to microbiologically confirmed H7 N9 admitted to our ICU over a 3-month period.RESULTS: Eight patients(mean age 57.38±16.75; 5 male) were diagnosed with H7 N9 in the first quarter of 2014. All developed respiratory failure complicated by acute respiratory distress syndrome(ARDS), which required MV in ICU. The baseline APACHE II and SOFA score was 11.77±6.32 and 7.71±3.12. The overall CT scores of the patients was 247.68±34.28 and the range of CT scores was 196.3–294.7. The average MV days was 14.63±6.14, and 4 patients required additional rescue therapies for refractory hypoxemia. Despite these measures, 3 patients died.CONCLUSION: In H7 N9-infected patients with ARDS, low tidal volume strategy was the conventional mode. RM as one of rescue therapies to refractory hypoxemia in these patients with serious architectural distortion and high CT scores, which could cause further lung damage, may induce bad outcomes and requires serious consideration. Prone ventilation may improve mortality, and should be performed at the early stage of the disease, not as a rescue therapy. | Hui Xie Zhi-gang Zhou Wei Jin Cheng-bin Yuan Jiang Du Jian Lu Rui-lan Wang | 2018 | World Journal of Emergency Medicine2018，9，2： | 9 |
| 18 | 鼻塞式同步间歇指令通气治疗早产儿呼吸窘迫综合征的疗效观察显示文摘目前,经气管插管的同步间歇指令通气(synchronized intermittent mandatory ventilation,SIMV)和鼻塞式持续气道正压通气(NCPAP)这两种呼吸支持模式已在临床得到广泛应用,并已经有效救治了大量危重早产儿[1]。我科经过多年研究实践,选择2012年7月至2015年7月本院新生儿重症监护室(NICU)收治的早产儿呼吸窘迫综合征(RDS)早产儿55例作为研究对象, | 胡鸿伟 程国平 刘勇 刘磊 宇丽 徐美玲 袁丹 | 2016 | 山西医药杂志2016，45，13： | 7 |
| 19 | Economic optimization on two time scales for a hybrid energy system based on virtual storage显示文摘This paper proposes an economic optimization method with two time scales for a hybrid energy system based on the virtual storage characteristic of a thermostatically controlled load(TCL). The optimization process includes two time scales in order to ensure accuracy and efficiency. Based on the forecast load and energy supply of the system, the first time scale is day-ahead economic operating optimization, carried out to determine the minimum operating cost for the whole day, and to find the period of greatest cost to which the second time scale optimization is applied. Using the virtual storage characteristic, the second time scale is short-term detailed optimization carried out for these particular hours. By dispatching thermal load in this period and adjusting energy supply accordingly, we can find the optimal economic performance, and customer requests are taken into account to ensure satisfaction. A case study in Tianjin, China illustrates the effectiveness of this method and proves that a TCL can make a great contribution to improving the economic performance of a hybrid energy system. | Jingjie YANG Bingqing GUO Bo QU | 2018 | Journal of Modern Power Systems and Clean Energy2018，6，5： | 7 |
| 20 | Application of ventilation simulation to spontaneous combustion control in underground coal mine:A case study from Bulianta colliery显示文摘Spontaneous combustion of residual coal in longwall goaf is a long standing hazard. Airflow leakage into goaf is a major driver to the hazard and this issue deteriorates where longwalls are operating in multiple seams and shallow covers because mining-induced cracks are very likely to draw fresh airflow into goaf due to presence of pressure differential between longwall face and surface. To study the problem more critically, a ventilation simulation package ‘‘Ventsim' is used to conduct a case study from Bulianta colliery. It was found that isolating and pressurizing active longwall panel can mitigate the problem and the pressure differential can be adjusted by varying performance of auxiliary fan and resistance of ventilation regulator. A booster ventilation system can also mitigate the problem by adjusting fan duties. Ventilation simulation is a powerful tool to study spontaneous combustion control in underground coal mine. | Liang Yuntao Zhang Jian Ren Ting Wang Zhongwei Song Shuanglin | 2018 | International Journal of Mining Science and Technology2018，28，2： | 7 |
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