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Objective. To investigate the mechanisms underlying the development of right heart-associated PE. Background. Right heart-related pulmonary edema (PE) refers to PE resulting from impaired right heart function caused by primary or secondary factors, which is common in critically ill patients. Although the clinical manifestations of different types of right heart-related PE are similar, the pathophysiological changes and treatment methods are significantly different. According to the hemodynamic mechanism, right heart-related PE is primarily classified into two types. One is the increase of right heart flow, including extravascular compression, intravascular compression, cardiac compression, and cardiac decompression. The other type is the abnormal distribution of pulmonary circulation, including obstruction, resistance, pleural decompression, or negative pressure. With the development of hemodynamic monitoring, hemodynamic data not only help us understand the specific pathogenesis of right heart-related PE but also assist us in determining the direction of therapy and enabling individualized treatment. Summary. This article presents a review on right heart-associated PE, with a perspective of hemodynamic analysis, and emphasizes the importance of right heart function in the management of circulation. Understanding the mechanism of right heart-associated PE will not only aid in better monitoring right heart function but also help intensivists make a more accurate identification of various types of PE in the clinic. [ABSTRACT FROM AUTHOR]

Objective. Pediatric patients are facing greater difficulties in radial catheterization for anatomic variation and smaller diameter. This study is to investigate the efficacy of phentolamine accompanied by lidocaine subcutaneously under ultrasound guidance on radial catheterization in pediatric patients. Methods. 66 pediatric patients were enrolled and randomly divided into saline group, phentolamine group, and phentolamine+lidocaine group. Baseline characteristics and surgical types were collected. Relevant solutions were subcutaneously injected, and catheterization was subsequently conducted under ultrasound guidance. Radial artery diameter and depth were measured, the success rate of catheterization and procedure time were calculated, and the complications were evaluated with ultrasonography. Results. No significant differences were observed in age, sex, weight, American Society of Anesthesiologists' classification, systolic blood pressure, diastolic blood pressure, heart rate, hemoglobin, and surgical types among three groups. Subcutaneously, the diameter in phentolamine and phentolamine+lidocaine groups increased significantly compared with the saline group. Moreover, the diameter also increased significantly after injection compared with that before injection both in the phentolamine and phentolamine+lidocaine groups. The first-attempt success rates were significantly higher while the procedure times of cannulation were shorter in the phentolamine and phentolamine+lidocaine groups than that in the saline group. Kaplan–Meier analysis showed that the overall procedure time was shorter in the phentolamine and phentolamine+lidocaine groups than the saline group. Overall complications and vasospasm incidence were lower in the phentolamine and phentolamine+lidocaine groups than the saline group. Conclusion. Phentolamine accompanied by lidocaine subcutaneous injection under ultrasound guidance improved the first-attempt success rate and reduced the complication of radial artery catheterization in pediatric patients. [ABSTRACT FROM AUTHOR]

Purpose. Sepsis becomes the main death reason in hospitals with rising incidence, causing a growing economic and medical burden. However, the genes related to the pathogenesis and prognosis of sepsis are still unclear, which is a problem that needs to be solved urgently. Materials and Methods. Gene expression profiles of GSE69528 were obtained from the National Center for Biotechnology Information. Limma software package got employed to search for differentially expressed genes (DEGs). Kyoto Encyclopedia of Genes and Genomes (KEGG) and Gene Ontology (GO) were used for enrichment analysis. Protein-protein interaction (PPI) network was built by the Search Tool for the Retrieval of Interacting Genes (STRING) database. Results. We screened 101 DEGs, containing 81 upregulated DEGs and 20 downregulated DEGs. GO analysis demonstrated that the upregulated DEGs were chiefly concentrated in negative regulation of response to interferon-gamma and regulation of granulocyte differentiation. KEGG analysis revealed that the pathways of upregulated DEGs were concentrated in prion diseases, complement and coagulation cascades, and Staphylococcus aureus infection. The PPI network constructed by upregulated DEGs contained 67 nodes (proteins) and 110 edges (interactions). Analysis of bioinformatics results showed that CEACAM8, MPO, and RETN were hub genes of sepsis. Conclusion. Our analysis reveals a series of signal pathways and key genes related to the mechanism of sepsis, which are promising biotargets and biomarkers of sepsis. [ABSTRACT FROM AUTHOR]