Repolarization changes during SVT initiation were caused mainly by concurrent hemodynamic change after SVT initiation with abrupt cycle length shortening.
Heated humidified high-flow nasal cannula; high-flow tracheal oxygen; conventional oxygen therapy; tracheostomy cuff; early cuff deflation Heated humidified high-flow oxygen therapy, administered using a nasal cannula, is called high-flow nasal cannula (HFNC). HFNC has been introduced and is used as a respiratory support mode in patients with respiratory disorders. HFNC is widely used in adults [1,2], children [3], and neonates [4,5]. The use of HFNC in current clinical practice is supported by evidence. However, current knowledge on the effects of high-flow tracheal oxygen (HFT) remains inconclusive. HFNC provides sufficient levels of both oxygen and airway humidity with a higher gas flow of up to 60 L/min [1,2]. Because of these advantages, HFNC has been a widely used device for when patients need respiratory support. HFNC has exhibited clinical benefits in hypoxemic respiratory failure [6-9], as an alternative to noninvasive ventilation [10], in post-extubation care [11], and in exercise training [12]. HFT can be delivered at a heated humidified high-flow mode as HFNC. However, the outcomes of HFNC use may not directly translate to those of HFT use. Both the mechanism of action and physiological effects appear different and require further investigation [13-15]. In the present editorial, we discuss the state of the art in HFT use, focusing on the practical use of HFT and the body of clinical evidence.
Limited therapeutic options are available for multidrug-resistant Acinetobacter baumannii (MDR-AB), and the development of effective treatments is urgently needed. The efficacy of four aerosolized antibiotics (gentamicin, amikacin, imipenem, and meropenem) on three different MDR-AB strains was evaluated using hypertonic saline (HS, 7 g/100 mL) as the aerosol carrier. HS aerosol effectively hindered biofilm formation by specific MDR-AB strains. It could also interrupt the swarming dynamics of MDR-AB and the production of extracellular polymeric substances, which are essential for biofilm progression. Biofilms protect the microorganisms from antibiotics. The use of HS aerosol as a carrier resulted in a decreased tolerance to gentamicin and amikacin in the biofilm-rich MDR-AB. Moreover, we tested the aerosol characteristics of antibiotics mixed with HS and saline, and results showed that HS enhanced the inhaled delivery dose with a smaller particle size distribution of the four antibiotics. Our findings demonstrate the potential of using “old” antibiotics with our “new” aerosol carrier, and potentiate an alternative therapeutic strategy to eliminate MDR-AB infections from a biofilm-disruption perspective.
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