(C) 2009 American Institute of Physics. [DOI: 10.1063/1.3063813]“
“Background: PD173074 solubility dmso Patients starting dialysis treatments are increasingly elderly and with high morbidity and mortality. Survival and factors influencing
mortality are discussed.
Methods: We studied 2,601 patients who started hemodialysis in Andalucia (Spain) between 2004 and 2007. Of these, 71 patients died in the first 90 days of hemodialysis treatment and were excluded. Three groups were considered: group A, 694 patients aged less than 60 years; group B, 1,203 patients between 60 and 75 years; and group C, 704 patients aged over 75. Survival and factors associated with mortality were studied.
Results: Mean survival was 46 months in group A, 41.6 in group B and 35 in the very elderly group. In univariate analysis using the
Cox proportional hazards model, survival in the very elderly patients was significantly influenced by low body mass index (BMI), venous catheter as initial vascular access, arterial hypertension, congestive heart failure (CHF), Kinase Inhibitor Library concentration late referral to nephrologist (<6 months), C-reactive protein (CRP) > 10 mg/dL, serum albumin < 3.5 g/dL, Kt/V (Daugirdas) < 1.2 and time of dialysis session < 180 minutes. In multivariate analysis, BMI, CHF, CRP, low serum albumin, Kt/V and time of dialysis session remained as independent predictors of mortality.
Conclusions: Survival of the very elderly patients who remained on hemodialysis more than 90 consecutive days was poor (about 3 years). Heart failure and malnutrition/inflammation are prognostic factors related
to mortality in these patients on chronic hemodialysis.”
To review perioperative airway management and ventilation strategy during the surgical removal of papilloma under suspension laryngoscopy in pediatric patients with severe airway obstruction.
Seventy pediatric patients with degree III and IV laryngeal obstruction who underwent suspension laryngoscopy selleck chemicals to remove laryngeal papillomatosis, between July 2005 and March 2009, were included in the study. All patients were intubated initially to secure the airway. Controlled ventilation through an endotracheal (ET) tube was used during the papilloma debulking near the glottis vera. Spontaneous ventilation or apneic technique was adopted based on the stage of the surgical procedure and the location of the remaining tumor. Hemodynamic parameters, pulse oxygen saturation (SpO(2)), and CO2 were closely monitored, and adverse events were recorded.
The duration of the surgical operation and the duration of the extubation period were 5-35 min and 5-20 min, respectively. Thirty cases with degree III and twenty cases with degree IV laryngeal obstruction received inhalation induction. Sixteen cases with degree III laryngeal obstruction were given an intravenous induction. Four patients admitted with a comatose status were emergently intubated without any anesthetics.