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- W3030952475 abstract "ObjectiveTo explore the incidence, causal factors and prognosis of acute cor pulmonale (ACP) complicating H7N9 influenza virus infection.MethodsA retrospective study was conducted. Twenty-one laboratory-confirmed H7N9 patients who required intensive care during March 2013 to September 2015 in the Affiliated First Hospital of Soochow University and Suzhou 5th People's Hospital were enrolled. The ACP was defined as right ventricular (RV) dilatation with a paradoxical septal motion at end-systole. All patients were divided into two groups (ACP group and non-ACP group), and the clinical data of all patients were analyzed retrospectively. The presentation, mechanical ventilation (MV) setting, the characteristics of bedside electrocardiogram (ECG) and echocardiography between the two groups were compared and analyzed.ResultsSix of 21 patients with H7N9 influenza virus infection developed ACP during hospitalization with the incidence of 28.6%, and with the presentation of tachycardia, unstabilized hemodynamics and decreased pulse blood oxygen saturation (SpO2). The media time from onset of influenza symptom to ACP occurrence was 11.00 (6.25, 20.50) days. On the day of ACP occurrence, the worst value of heart rate was (102.83±20.53) bpm, mean arterial pressure was (81.83±12.14) mmHg (1 mmHg = 0.133 kPa), and oxygenation index was (132.40±74.90) mmHg, and SpO2 was 0.863±0.051, there were no statistically significant differences in above parameters as compared with those of non-ACP group except SpO2. The media from MV to ACP occurrence was 3.50 (1.75, 6.75) days. The level of positive end-expiratory pressure (PEEP) and airway plateau pressure (Pplat) in ACP group were significantly higher than those of non-ACP group [PEEP (cmH2O, 1 cmH2O = 0.098 kPa): 15.17±3.71 vs. 11.73±2.57, Pplat (cmH2O): 27.50±1.05 vs. 23.09±4.37, both P 0.05). The proportion of right axis deviation in ACP group was significantly higher than that of non-ACP group (83.3% vs. 13.3%, P 0.05; 100.0% vs. 20.0%, P 0.05), while the intensive care unit (ICU) mortality in ACP patients was significantly higher than that of non-ACP patients (83.3% vs. 26.7%, P < 0.05).ConclusionsThe prevalence of ACP in critically ill patients with H7N9 influenza virus infection was high. MV was an important factor responsible for the development of ACP with severe H7N9 influenza virus infection. Strengthen the monitoring and management of RV dysfunction at early stage was indispensable because of the poor prognosis and non specificity clinical symptoms of ACP in severe H7N9 virus infected patients.Key words: H7N9; Acute cor pulmonale; Intensive care unit; Echocardiography" @default.
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- W3030952475 date "2016-09-10" @default.
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- W3030952475 title "The characteristics of acute cor pulmonale in critically ill patients with H7N9 influenza virus infection" @default.
- W3030952475 doi "https://doi.org/10.3760/cma.j.issn.2095-4352.2016.09.011" @default.
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