We identified risk factors associated with intraoperative or with postoperative hypoxemia in rigid bronchoscopy which included patient age, type of FB, duration of surgical procedure, pneumonia before the procedure, ventilation mode, and duration of emergence from anesthesia. These results provide evidence that will help clinicians to reduce the incidence of hypoxemia in high-risk children.

ObjectivesClinical observation, as well as randomized controlled trials, indicated an increasing rate of postoperative cognitive dysfunction (POCD) with increasing depth of general anesthesia. However, the findings are subject to bias due to varying degree of analgesia. In this trial, we compared the rate of POCD between patients receiving light versus high anesthesia while holding analgesia comparable using nerve block.MethodsElderly patients (≧60 years) receiving elective total knee replacement were randomized to receive the surgery under general anesthesia at BIS 40–50 (LOBIS group) or BIS 55–65 (HIBIS group). The femoral nerve and the sciatic nerve were blocked under ultrasonic guidance in all patients before induction. Cognitive performance was assessed with Montreal cognitive assessment (MoCA) at the baseline and 1d, 3d, and 7d after the surgery. POCD was defined by Z score of >1.96 using cross‐reference. The extubation time and recovery time were also compared.ResultsA total of 66 patients were randomized; 60 (n = 30 per group) completed trial as the protocol specified. POCD occurred in six patients (20%) in the LOBIS group vs. in one patient (3.3%) in the HIBIS group (Figure 3, p = .04). In all seven cases, the diagnosis of POCD was based on MoCA assessment on 1d after the surgery. Assessment in 3d and 7d after surgery did not reveal POCD in any case. Extubation time was longer in the LOBIS group (12.16 ± 2.58 vs. 5.77 ± 3.01 min in the HIBIS group (p < .001)). The time of comeback of directional ability was 13.47 ± 3.14 and 6.17 ± 3.23 min in the LOBIS and HIBIS groups, respectively (p < .001).ConclusionsIn elderly patients receiving a total knee replacement, lighter anesthesia could reduce the rate of POCD with complete analgesia during surgery.

Spinal morphine interacts with systemic morphine or buprenorphine in asupraadditive manner. This mode of interaction most probably results from the simultaneous activation of spinal and supraspinal antinociceptive systems. Supraspinal structures played a more important role in the antinociceptive effect of experimental combinations than structures of the spinal cord.

Background This study aimed to investigate clinical characteristics, laboratory indexes, treatment regimens, and short‐term outcomes of severe and critical coronavirus disease 2019 (COVID‐19) patients. Methods One hundred and sixty one consecutive severe and critical COVID‐19 patients admitted in intensive care unit (ICU) were retrospectively reviewed in this multicenter study. Demographic features, medical histories, clinical symptoms, lung computerized tomography (CT) findings, and laboratory indexes on admission were collected. Post‐admission complications, treatment regimens, and clinical outcomes were also documented. Results The mean age was 59.38 ± 16.54 years, with 104 (64.60%) males and 57 (35.40%) females. Hypertension (44 [27.33%]) and diabetes were the most common medical histories. Fever (127 [78.88%]) and dry cough (111 [68.94%]) were the most common symptoms. Blood routine indexes, hepatic and renal function indexes, and inflammation indexes were commonly abnormal. Acute respiratory distress syndrome (ARDS) was the most common post‐admission complication (69 [42.86%]), followed by electrolyte disorders (48 [29.81%]), multiple organ dysfunction (MODS) (37 [22.98%]), and hypoproteinemia (36 [22.36%]). The most commonly used antiviral drug was lopinavir/ritonavir tablet. 50 (31.06%) patients died, while 78 (48.45%) patients healed and discharged, and the last 33 (20.50%) patients remained in hospital. Besides, the mean hospital stay of deaths was 21.66 ± 11.18 days, while the mean hospital stay of discharged patients was 18.42 ± 12.77 days. Furthermore, ARDS (P < .001) and MODS (P = .008) correlated with increased mortality rate. Conclusion Severe and critical COVID‐19 presents with high mortality rate, and occurrence of ARDS or MODS greatly increases its mortality risk.

An efficient face detection algorithm which can detect multiple faces in cluttered environment is proposed. First of all, morphological operations and labeling process were performed to obtain the eyeanalogue segments. Based on some matching rules and the geometrical relationship on a face, eye-analogue segments were grouped into pairs and used to locate potential face regions. Finally, the potential face regions were verified via a trained neural network and the true faces were determined by optimizing a distance function. Since the morphology-based eye-analogue segmentation process can efficiently locate the potential eye-analogue regions, the subsequent processing only has to deal with 5-10% area of the original image. Experiments demonstrate that an approximately 94% success rate is reached and the relative false detection rate is very low.