Higher Respiration Rates Research Articles

Soluble ST2 concentrations associate with in-hospital mortality and need for mechanical ventilation in unselected patients with COVID-19

ObjectiveSoluble ST2 (sST2) reflects inflammation, endothelial dysfunction and myocardial fibrosis, is produced in the lungs and is an established biomarker in heart failure. We sought to determine the role of...

Performance features and mortality prediction of the 4C Score early in COVID-19 infection: a retrospective study in Saudi Arabia

The ISARIC4C consortium developed and internally validated the 4C Score for prediction of mortality only in hospitalized patients. We aimed to assess the validity of the 4C Score in mortality...

Storage Property Is Positively Correlated With Antioxidant Capacity in Different Sweet Potato Cultivars.

Sweet potato decays easily due to its high respiration rate and reactive oxygen species (ROS) accumulation during postharvest storage. In this study, we explored the relationship between antioxidant capacity in leaves and storage properties in different sweet potato cultivars, the tuberous roots of 10 sweet potato cultivars were used as the experimental materials to analyze the storage property during storage at 11–15°C. According to the decay percentage after 290 days of storage, Xu 32 was defined as a storage-tolerant cultivar (rot percentage less than 25%); Xu 55-2, Z 15-1, Shangshu 19, Yushu, and Zhezi 3 as above-moderate storage-tolerant cultivars (rot percentage ranging from 25 to 50%); Sushu 16, Yanshu 5, and Hanzi as medium-storable cultivars (rot percentage 50–75%); and Yan 25 as a storage-sensitive cultivar (rot percentage greater than 75%). Meanwhile, analysis of the α-amylase activity in root tubers of the 10 sweet potato cultivars during storage indicated that α-amylase activity was lowest in the storage-tolerant cultivar Xu 32 and highest in the storage-sensitive cultivar Yan 25. Evaluation of antioxidant enzyme activities and ROS content in the leaves of these 10 cultivars demonstrated that cultivar Xu 32, which showed the best storage property, had higher antioxidant enzyme activity [superoxide dismutase (SOD), catalase (CAT), ascorbate peroxidase (APX), and peroxidase (POD)] but lower lipoxygenase (LOX) activity, hydrogen peroxide (H2O2) and malondialdehyde (MDA) contents, and superoxide anion radical (O2⋅–) production rates compared with those of the storage-sensitive cultivar Yan 25 and the medium-storability cultivars Hanzi, Yanshu 5, and Sushu 16. Additionally, principal component analysis (PCA) suggested that sweet potato cultivars with different storage properties were clustered separately. Correlation and heat map analysis further indicated that CAT, APX, POD, and SOD activities were negatively correlated with α-amylase activity, while LOX activity and MDA and H2O2 contents were negatively correlated with the storage property of sweet potato. Combined, our findings revealed that storage property is highly correlated with antioxidant capacity in sweet potato leaves and negatively correlated with α-amylase activity in tuberous roots, which provides a convenient means for the screening of storage-tolerant sweet potato cultivars.

Demographic and Clinical Features Association With Mortality in Patients With COVID-19: A Cross-Sectional Study in the West of Iran

The coronavirus disease 2019 (COVID-19) pandemic as an emergency public health concern has caused hundreds of thousands of deaths in the world. Identifying predictors of death in COVID-19 patients is a key to improving survival and helping patients triage, better management, and assist physicians and health care. The present study was conducted on 512 positive COVID-19 patients confirmed by real-time PCR hospitalized in Sina Hospital, Hamadan, in 2020. The data of demographic characteristics, clinical manifestations, laboratory findings, chest examination, and disease outcome were collected. The logistic regression model was performed to explore the predictors of in-hospital mortality. Among 512 patients, 57 (11.1%) deaths have occurred. The adjusted odds ratios (OR) estimate of death in COVID-19 for patients with age more than 60 years versus those lower than 60 years was 3.15 (95% CI: 1.06, 9.37). The adjusted OR estimate of death in patients with hypertension comorbidity versus those with no comorbidity was 3.84 (95% CI: 1.27, 11.59). In addition, the adjusted OR estimate (95% CI) of death in patients with respiratory rate above 30 per minute, BUN >20 mg/dL, LDH >942 U/L and SGOT >45 U/L against lower than those values was respectively 10.72 (1.99, 57.68), 5.85 (2.19, 15.63), 13.42 (2.17, 83.22) and 2.86 (1.02, 8.05). The risk of death was higher among the patients with multiple comorbidity diseases, systolic BP lower than 90 mmHg, SPO2 lower than 88 and more than ten days hospitalization in comparison with COVID-19 patients with no comorbidity disease (P=0.002), systolic BP higher than 90 mmHg (P=0.002), SPO2 higher than 88 (P<0.001) and hospitalization for lower than ten days (P=0.012). Our findings suggest that older age, pre-existing hypertension and/or multiple co-morbidities, high respiratory rate, elevated BUN, LDH and SGOT, low systolic BP, and hypoxemia were independently associated with in-hospital mortality in COVID-19 patients. These results can be helpful for physicians and health care workers to improve clinical management and appropriate medical care of COVID-19 patients.

Abstract 12134: Risk of In-Hospital Deterioration for Children With Single Ventricle Physiology

Introduction: Children with single ventricle physiology (SV) are at high risk of in-hospital morbidity and mortality, with much of that increased risk coming in the first year of life. Understanding which children are at the highest risk for clinical deterioration may allow for increased monitoring and earlier escalation of care, with associated decreased mortality. Methods: We conducted a retrospective chart review of all admissions to the pediatric cardiology non-ICU inpatient service from 2014 - 2018 for children < 18 years old. Clinical deterioration was defined as an unplanned transfer to the ICU or inpatient mortality. Children with SV were selected by diagnosis codes. Results: From the entire cohort of 1612 pediatric cardiology admissions (56 % male, 25% SV), 288 admissions had a deterioration event including 26 deaths. Infants less than one year with SV (n = 197 admissions) were significantly more likely to have a deterioration event (107 events over 62 admissions with an event) than the overall pediatric cardiology cohort (OR 2.11, 95% CI 1.52-2.93). Among infants with SV, those with a deterioration event were significantly younger (median 1.7 v 4.3 months, p < 0.001). Further, at baseline they had significantly lower oxygen saturation (84% v 87%, p < 0.01), lower systolic blood pressure (85mmHg v 90mmHg, p< 0.02), higher respiration rate (48 v 44, p < 0.01), and higher hematocrit (44.0 v 40.2, p < 0.005) compared to those who remained stable. Mean Pediatric Early Warning Scores (PEWS) were significantly higher for infants with SV who had a deterioration event (1.4 v 0.9, p < 0.001) and PEWS scores significantly increased in the 48 hours prior to an event (p < 0.001). Of the 104 non-death events, 61 required an increase in oxygen support and 51 required a fluid bolus prior to the event (p < 0.001). Conclusions: Infants with SV are at high risk for clinical deterioration. There are baseline differences in vital signs and lab work between those that remain stable and those that have a deterioration event. PEWS scores and oxygen and fluid treatment significantly increase prior to deterioration events. Leveraging data from the Electronic Medical Record to identify the highest risk patients may allow for earlier detection and intervention to prevent clinical deterioration.

Effect of azithromycin on incidence of acute respiratory exacerbations in children with HIV taking antiretroviral therapy and co-morbid chronic lung disease: a secondary analysis of the BREATHE trial.

BackgroundIn the BREATHE trial weekly azithromycin decreased the rate of acute respiratory exacerbations (AREs) compared to placebo among children and adolescents with HIV-associated chronic lung disease (CLD) taking antiretroviral therapy (ART). The aim of this analysis was to identify risk factors associated with AREs and mediators of the effect of azithromycin on AREs.MethodsThe primary outcome of this analysis was the rate of AREs by study arm up to 49 weeks. We analysed rates using Poisson regression with random intercepts. Interaction terms were fitted for potential effect modifiers. Participants were recruited from Zimbabwe and Malawi between15 June 2016 and 4 September 2018.FindingsWe analysed data from 345 participants (171 allocated to azithromycin and 174 allocated to placebo). Rates of AREs were higher among those with an abnormally high respiratory rate at baseline (adjusted rate ratio (aRR) 2.08 95% CI 1.10-3.95 p-value 0.02) and among those with a CD4 cell count <200 cells/mm3 (aRR 2.71; 95% CI 1.27-5.76; p-value 0.008). We found some evidence for variation in the effect of azithromycin by sex (p-value for interaction=0.07); males had a greater reduction in the rate of ARE with azithromycin treatment than females. We found that azithromycin had a greater impact on reducing AREs in participants with chronic respiratory symptoms at baseline, those on 1st line ART, with a FEV1 score >-2 and participants without baseline resistance to azithromycin. However, there was no statistical evidence for interaction due to low statistical power.InterpretationThese may represent subgroups who may benefit the most from treatment with weekly azithromycin, which could help guide targeted treatment.FundingThere was no funding source for this post hoc analysis.

Performance of Automated Point-of-Care Respiratory Rate Counting versus Manual Counting in Children under Five Admitted with Severe Febrile Illness to Kisantu Hospital, DR Congo.

To improve the early recognition of danger signs in children with severe febrile illness in low resource settings, WHO promotes automated respiratory rate (RR) counting, but its performance is unknown in this population. Therefore, we prospectively evaluated the field performance of automated point-of-care plethysmography-based RR counting in hospitalized children with severe febrile illness (<5 years) in DR Congo. A trained research nurse simultaneously counted the RR manually (comparative method) and automatically with the Masimo Rad G pulse oximeter. Valid paired RR measurements were obtained in 202 (83.1%) children, among whom 43.1% (87/202) had fast breathing according to WHO criteria based on manual counting. Automated counting frequently underestimated the RR (median difference of −1 breath/minute; p2.5–p97.5 limits of agreement: −34–6), particularly at higher RR. This resulted in a failure to detect fast breathing in 24.1% (21/87) of fast breathing children (positive percent agreement: 75.9%), which was not explained by clinical characteristics (p > 0.05). Children without fast breathing were mostly correctly classified (negative percent agreement: 98.3%). In conclusion, in the present setting the automated RR counter performed insufficiently to facilitate the early recognition of danger signs in children with severe febrile illness, given wide limits of agreement and a too low positive percent agreement.

Optimization of ozone concentration and storage time in green asparagus (Asparagus officinalis L.) using response surface methodology

Background: Asparagus (Asparagus officinalis L.) green is a vegetable with a great demand worldwide, and likewise, it is highly perishable due to its high respiration rate that accelerates its senescence. Disinfection of vegetables after their harvest is an obligatory practice that can reduce losses by decomposition due to the attack of microorganisms. Therefore, it is vital to preserving its microbiological and sensory characteristics to reach the final consumer. Objective: To evaluate the effect of gaseous ozone (0 to 10 ppm) and storage time (0 to 30 days) on phenol content, overall appearance, count of molds, psychrophilic bacteria, and viable mesophilic aerobes. Methods: the response surface methodology was used, applying a rotatable central composite design. Results: The results indicated that there was a significant influence (p &lt;0.05) of the independent variables on the characteristics studied, as well as an adequate lack of fit of the quadratic regression model (p&gt; 0.05). By means of the contour superposition technique, it was determined that the optimal conditions for the highest retention of phenol content (16.99 mg/g) and overall appearance (7.61 points) and lower counts of viable aerobic mesophilic bacteria (5.3 x 103 CFU/g) they corresponded to 10 ppm of gaseous ozone up to 25.91 days of storage, with adequate quality characteristics in the shoots. Conclusion: the region of interest was determined for optimal retention of phenol content and overall appearance, and a lower count of viable aerobic mesophilic bacteria in green asparagus during postharvest, suggesting to use the initial application of ozone gas at 10 ppm allowing 25.9 days storage at 1 °C. The results indicate that this technology is a good alternative in the conservation of fresh vegetables.

Chitosan and graphene oxide-based biodegradable bags: An eco-friendly and effective packaging alternative to maintain postharvest quality of ‘Palmer’ mango

Mango is a highly appreciated tropical fruit with high respiration rate and ethylene production, which makes it highly perishable after harvest. The objective of this study was to evaluate the effect of chitosan and graphene oxide-based biodegradable bags on the postharvest quality of ‘Palmer’ mangoes during cold storage. The fruit were harvested at the recommended maturity stage and were stored for 56 days at 12 °C without bagging (control), as well as in chitosan-based bag, chitosan-based bag with graphene oxide, and polyethylene-based bag. According to the results, the bags evaluated in our study delayed mango ripening, maintaining external appearance, skin and flesh colors, firmness, soluble solids (SS), titratable acidity (TA), SS/TA ratio, β-carotene and chlorophyll contents in the fruit. In addition, bagging the fruit reduced weight loss, respiration rate and anthracnose (Colletotrichum gloeosporioides) incidence and severity during storage. Our results suggest that chitosan-based biodegradable bags are an ecological and effective alternative to maintain postharvest quality of ‘Palmer’ mango during cold storage.

Characteristics of corn starch-based edible coating enriched with curry leaf extract on quality of the strawberry (Fragaria x ananassa Duch.)

Strawberry is one of the most popular tropical fruits in Indonesia. The fruit has a concise shelf life and quickly deterioration after harvesting due to mechanical injury, physiological disorders, water loss, fungal growth, and high respiration rates. Postharvest technology is one technique that can maintain fruit quality and extend shelf life, one of which is a coating technique called edible coating. The edible coating layer of corn starch with the addition of curry leaf extract has antibacterial activity that can inhibit the growth rate of microorganisms. This study aimed to determine the characteristics of the edible coating solution produced from corn starch with the addition of curry leaf extract to produce the best edible coating layer. This study used a factorial completely randomized design experimental method, which consisted of treatment with curry leaf extract concentration (8%, 10%, and 12%) and dipping time (4, 5, and 6 minutes) with three repetitions. The result showed a significant delay in weight loss and total dissolved solids in strawberries compared to the uncoated control strawberries. In addition, the edible coatings had positive results in organoleptic based on panelists’ acceptance of color, aroma, taste, texture, and overall. These findings suggest that using 8% curry leaf extract with 4 minutes dipping time could be favorable to extend the shelf-life and maintain the quality of strawberry fruit.

COMPARISON BETWEEN THE EFFECT OF CEFTRIAXONE AND AZITHROMYCIN IN THE MANAGEMENT OF COMMUNITY ACQUIRED PNEUMONIA PATIENTS IN HOSPITAL SETTING

Introduction: pneumonia can be defined as symptoms that incorporate acute lower respiratory tract (LRT) infection, comprising of cough and a minimum of one more LRT symptom, in parallel to any other ‘systemic symptom and new focal signs on chest examination. Annually, there were approximately 151.8 million cases about a decade ago and among them 8.7% (13.1 million) required hospitalization. India ranks in top five countries on basis of CAP load with more than 23% worldwide cases.&#x0D; Materials and Methods: the design of this study is a Retrospective Cohort. A total of 123 patients ranging from 3 years old to 17 years old with a average of 9.90 years old, with bacterial pneumonia were included in the study. The diagnostic criteria of Infectious Disease Society of America and the British Thoracic Society were used in this study to determine the diagnosis and conclusion of the study. Out of 123 patients, 65 patients (Group 1) were given azithromycin at the initial dosage of 10 mg/kg followed by 5 mg/kg for 2 to 5 days while 58 patients (Group 2) were given ceftriaxone at the single intramuscular dose of 50 mg/kg. The clinical criteria and Likelihood criteria was determined before and after the treatment in both the groups to compare the efficiency of the two drugs. The adverse effects of the two drugs were also considered.&#x0D; Result: the clinical criteria and Likelihood Ratio was determined before starting the treatment. On Day 5th,after completion of the treatment in both the groups,all the patients were again re-assessed. Group 1 showed more improvement as compared to group 2 patients as the fever in group 1 patients came down to 2.43% from 52.84% of the total number of patients. A high respiratory rate was found in 2.43% of 123 patients in the case of group 1 as compared to 4.06% of 123 patients in the case of group 2. Group 1 patients showed adverse effects like diarrhea, itching and nausea while group 2 patients showed tarry stool, sore throat and weakness as adverse effects. 12.19% of the total patients showed adverse effects from group 1 while 35.77% of the total patients showed adverse effects from group 2.&#x0D; Conclusion: the study concludes that although both of the drugs used are effective in managing CAP. Azithromycin regimen has a significantly beneficial as compared to a single intramuscular dose of ceftriaxone.&#x0D; Keywords: pneumonia, CAP, azithromycin, ceftriaxone, antibiotic

Comparative clinical characteristics among different age group of adult COVID-19 patients: A multicenter study.

BackgroundCoronavirus disease (COVID‐19) is a global infectious disease with a large burden of illness and high health care costs. This study aimed to compare clinical features among adult COVID‐19 patients in different age groups.MethodsLaboratory‐confirmed adult COVID‐19 infection cases between December 31, 2019 to March 8, 2020 obtained from Neighboring Cities. Patients were divided into five age groups. Clinical characteristics were compared among different age groups.ResultsOf 299 cases, median age was 44 and 158 (53%) were male. A total of 53.3% of 30–40 years, 50% of 40–50 years, 36.6% of <30 years and 36.2% of 50–60 years were primary case, none of the elderly were primary case. Among all the observed symptoms, only symptom of dyspnea was significantly different between the elderly group and other groups (p < .001). Proportion of severe or critical type was 2.4%, 5.3%, 9.5%, 14.5%, and 35% in patients with age <30, 30–40, 40–50, 50–65, ≥65, respectively. A total of 285 patients (95.3%) were cured and discharged, 12 patients (4.0%) were still on medical treatment in hospital. There were 2 (0.7%) deaths which occurred among persons ≥65 years. Patients with a history of chronic heart disease had a more than a 56 times higher risk for severe or critical type of COVID‐19 than those without a history of chronic heart disease (odds ratio [OR]: 56.038, 95% confidence interval [CI]: 2.764–1136.053, p = .009). Old age (OR: 1.055, 95% CI: 1.016–1.095, p = .006), high heart rate in admission (OR: 1.085, 95% CI: 1.03–1.144, p = .002), high respiratory rate in admission (OR: 1.635, 95% CI: 1.093–2.431, p = .017) were independently associated with severe or critical type in COVID‐19.ConclusionsProportion of severe or critical type increased with old age groups. Adults with old age and high heart rate, respiratory rate in admission and history of chronic heart disease were associated with severe or critical type in COVID‐19.

Resolución quirúrgica del fecaloma de Mini Horse: reporte de caso

The presence of fecalomas in horses is related to accidental ingestion of substances such as pieces of rope, bedding, plastic and other materials, taking to an ingestion compaction that can cause obstruction and distension of intestinal loops. It is a common condition that can be found in ponies, mini horses and foals, causing an obstruction, most of the time, in the smaller colon. The present work reports a case of colic syndrome in a 2-year-old Mini Horse, with signs of abdominal discomfort for two days. The physical examination revealed high heart and respiratory rate, hypomotility on auscultation, abdominal distension, pale mucous membranes with the presence of a toxemic halo and pyrexia. Analysis of peritoneal fluid revealed an increase in leukocytes. The blood count identified leukopenia. The animal was subjected an exploratory laparotomy and identified the presence of a fecaloma in the proximal third of the smaller colon and a pelvic flexure retroflexion.

How children experience virtual reality travel: a psycho-physiological study based on flow theory

PurposeDrawn from flow theory, this study aims to explore children’s flow experiences in virtual reality (VR) by examining the relationships between VR experience length, arousal and flow experience (time estimation and enjoyment).Design/methodolog/approachA within-subject laboratory experiment was conducted using 9D VR and iMEC 12. A total of 47 children participated in this study. Both survey data and physiological data were collected.FindingsThe results revealed that longer VR videos evoked lower arousal, higher respiratory rates and less enjoyment among child participants than shorter videos. This study also verified the mediating effects of respiratory rates measured arousal on time estimations and self-reported arousal in terms of enjoyment.Originality/valueThis study fills a research gap related to children’s flow experiences in VR, as children’s voices remain limited in tourism research. The study findings offer meaningful insights for destination marketers to leverage the growth of parent-child tours and the increasing effects of VR on the tourism industry.

Noninvasive Ventilation in the Management of Respiratory Failure Due to COVID-19 Infection: Experience From a Resource-Limited Setting

ObjectiveTo study the role of noninvasive ventilation (NIV) in Severe Acute Respiratory Syndrome-Coronavirus 2 (SARS-CoV2) related acute respiratory failure (C-ARF). Patients and MethodsPatients with C-ARF managed on NIV were categorized as NIV success or failure (death or intubation). Factors associated with failure were explored using regression analysis and expressed as odds ratio (OR) with 95% CI. ResultsBetween April 1, 2020, and September 15, 2020, a total of 286 patients with a mean ± SD age of 53.1±11.6 years and Acute Physiology and Chronic Health Evaluation II score of 11.1±5.5 were initiated on NIV. Of the 182 patients (63.6%) successfully managed on NIV alone, 118 had moderate or severe acute respiratory distress syndrome. When compared with NIV success, NIV failure was associated with lower admission PaO2 to fraction of inspired oxygen ratio (P<.001) and higher respiratory rate (P<.001). On penalized logistic regression analysis, NIV failure was associated with higher Acute Physiology and Chronic Health Evaluation II score (OR, 1.12; 95% CI, 1.01 to 1.24), severe acute respiratory distress syndrome (OR, 3.99; 95% CI, 1.24 to 12.9), D-dimer level of 1000 ng/mL DDU (to convert to mg/L, divide by 1000) or greater (OR, 2.60; 95% CI, 1.16 to 5.87), need for inotropes or dialysis (OR, 12.7; 95% CI, 4.3 to 37.7), and nosocomial infections (OR, 13.6; 95% CI, 4.06 to 45.9). Overall mortality was 30.1% (86/286). In patients requiring intubation, time to intubation was longer in nonsurvivors than survivors (median, 5; interquartile range, 3-8 vs 3; interquartile range, 2-3 days; P<.001). ConclusionNoninvasive ventilation can be used successfully in C-ARF. Illness severity and need for non–respiratory organ support predict NIV failure.

Влияние интенсивности контактов с внешней средой на уровень адаптационных возможностей полярников в условиях антарктической зимовки

The research was conducted by a member of the 60th Russian Antarctic Expedition at the all-yearround Mirny Station. The aim was to study what influence contact intensity with the outside environment has on adaptive capabilities of polar station staff. The level of adaptive capabilities was evaluated using the method of cardio-respiratory synchronism, assessing the index of regulatory and adaptive status (IRAS). This method had been developed at the Normal Physiology Department of Kuban State Medical University under the supervision of Prof. V.M. Pokrovsky. It is based on recording the synchronization parameters of controlled high respiratory rate and heart rate. We compared IRAS dynamics of two aerologists during one year of wintering. The subjects had similar anthropometric data, health status and working conditions, the same length of Antarctic wintering (6 years) and were in the same age group. Contact intensity with the outside environment was determined by varying periods spent outside the station premises, mostly due to the lay-out of the residential and amenity buildings (canteen, leisure area, medical unit, gym). This period ranged from 2 to 7 hours on different days. The negative IRAS dynamics, being a marker of human adaptive capabilities, allowed us to identify the relationship between the intensity of environmental influence and the level of the body’s adaptive abilities in one of the expedition members who had been exposed to stronger environmental effects. The authors conclude that proper organization of off-duty periods aimed to decrease the influence of the outside environment will contribute to improving the health of the station staff and optimize their living conditions.

38 Risk Factors of Sepsis Among Patients With qSOFA

There have been concerns that some patients with sepsis—life-threatening organ dysfunction caused by a dysregulated host response to infection—may be overlooked with a quick Sequential Organ Failure Assessment (qSOFA)≥2 in the emergency department (ED). Despite this, little is known about the risk factors associated with sepsis among patients with qSOFA<2 in the ED. This is a retrospective cohort study using ED data from a large tertiary medical center in Japan 2018- 2020. We included adult patients (aged ≥18 years) presenting to the ED with suspected infection (eg, having a fever) and qSOFA<2. The primary outcome was the diagnosis of sepsis based on the Sepsis-3 criteria (defined as septic patients). We compared patient characteristics (eg, demographics, vital signs upon the initial triage, chief complaint, and comorbidities) between septic and non-septic patients. Additionally, we identified the potential risk factors of sepsis among patients with qSOFA<2 using a multivariable logistic regression model. We identified 151 (7%) septic patients among 2, 025 adult patients with suspected infection and qSOFA<2. Compared with non-septic patients, septic patients were likely to be older and have vital signs suggestive of imminent sepsis (eg, high respiratory rate). In the multivariable logistic regression model, the potential risk factors of sepsis among patients with qSOFA<2 were older age (adjusted OR, 1.92 [95% CI 1.19- 3.19]), vital signs suggestive of imminent sepsis (eg, adjusted OR of altered mental status, 3.50 [95% CI 2.25- 5.50]), receipt of oxygen therapy upon arrival at the ED (adjusted OR, 1.91 [95% CI 1.38-2.26]), chief complaint of sore throat (adjusted OR, 2.15 [95% CI 1.08-4.13]), and the presence of comorbid diabetes mellitus, ischemic heart disease, and chronic kidney disease (eg, adjusted OR of diabetes mellitus, 1.47 [95% CI 1.10-1.96]). On the contrary, high systolic blood pressure, and chief complaint of abdominal and chest pain were associated with a lower risk of sepsis (eg, adjusted OR of abdominal pain, 0.26 [95% CI 0.14-0.45]). We found that older age, vital signs prognosticating sepsis, and the presence of some comorbidities were the potential risk factors of sepsis in patients with qSOFA<2. To prevent missed diagnoses of sepsis, we should treat patients with these potential risk factors more cautiously.

Barotrauma, invasive ventilation, and timing of tocilizumab as predictors of mortality along with inflammatory markers and comorbidities in critically ill COVID-19 patients: A retrospective study.

Barotrauma, invasive ventilation, and timing of tocilizumab as predictors of mortality along with inflammatory markers and comorbidities in critically ill COVID-19 patients: A retrospective study.

Performance of the Uni-Vent Eagle™ Model 754 ventilator under hyperbaric conditions

Critically ill patients needing mechanical ventilation may require hyperbaric oxygen therapy. Some institutions still use ventilators that were available prior to the advent of hyperbaric-specific units, such as the Uni-Vent Eagle™ model 754. Here we examine the performance of the Uni-Vent model 754 under hyperbaric conditions and investigate concerns of an oxygen leak in the ventilator housing, which poses a fire risk. We studied the ventilator at 1.0, 2.4 and 2.8 ATA in assist control mode using a Michigan test lung and a variety of tidal volumes and respiratory rates. We recorded the delivered volumes, peak pressures, and oxygen percentages within the hyperbaric chamber at 2.4 and 2.8 ATA and within the ventilator housing. At those pressures the ventilator delivered approximately 25% less volume than at 1.0 ATA. We observed breath stacking at high respiratory rates, but this was blunted at both 2.4 and 2.8 ATA. Oxygen levels did not rise in the housing during our investigation. In addition, we fit a linear regression to the data comparing set tidal volumes and delivered tidal volumes in order to model the changes observed. Hyperbaric conditions caused decreased delivered tidal volumes in a depth-dependent fashion, and oxygen levels within the housing did not rise. The Uni-Vent Eagle model 754 performed safely and effectively at depth but requires spirometry to correctly program desired ventilator settings.

Understanding inequalities in COVID-19 outcomes following hospital admission for people with intellectual disability compared to the general population: a matched cohort study in the UK

ObjectivesThis study explores the hospital journey of patients with intellectual disabilities (IDs) compared with the general population after admission for COVID-19 during the first wave of the pandemic (when demand...