Abstract Introduction: The purpose of this study was to investigate the feasibility and superiority of using the WeChat platform for midterm clinical follow-up of children who underwent transthoracic device closure for ventricular septal defects (VSDs). Methods: Ninety children with VSDs who underwent transthoracic device closure were divided into a WeChat follow-up group (WFU group) and an outpatient follow-up group (OFU group). The patients were followed up via WeChat or at an outpatient clinic three months and one year after discharge. The incidences of adverse events, associated complications, costs and time spent, loss to follow-up rate, medication adherence, and overall satisfaction were recorded. Results: There was no statistically significant difference in the incidence of adverse events or postoperative complications between the two groups. Also, the loss to follow-up rate was similar between them. Compared with the OFU group, there were significant statistical advantages in the WFU group regarding the total time and cost spent, medication adherence, and satisfaction. Conclusion: The use of the WeChat platform in midterm clinical follow-up of children who underwent transthoracic device closure for VSDs has the advantages of reducing financial and time burdens, facilitating high medication adherence, and leading to high satisfaction.

Abstract Introduction: The objective of this study was to investigate the effect of mivacurium in the application of fast-track anesthesia for transthoracic device closure of ventricular septal defects (VSDs) in children. Methods: The data of 108 children who underwent transthoracic device closure of VSDs from December 2018 to June 2020 were recorded and analyzed. All children were divided into group M (mivacurium group, n=55) and group C (cisatracurium group, n=53) according to the different muscle relaxant drug used. Results: No statistically significant differences in general preoperative data, intraoperative hemodynamic changes, or the incidence of adverse reactions were noted between the two groups (P>0.05). However, the intubation condition rating of children in group M was better than that in group C. The onset time, duration of clinical action and recovery index of the muscle relaxant, postoperative mechanical ventilation duration, and length of intensive care unit stay in group M were significantly lower than those in group C (P<0.05). Conclusion: It is safe and feasible to use mivacurium as a muscle relaxant in children undergoing fast-track cardiac anesthesia during transthoracic device closure of VSDs.

RESUMO Objetivo: Avaliar sistematicamente os efeitos da continuous positive airway pressure (CPAP, pressão positiva contínua nas vias aéreas) na pressão arterial em pacientes com hipertensão resistente e apneia obstrutiva do sono (AOS). Métodos: Estudos que investigassem os efeitos da CPAP na pressão arterial em pacientes com hipertensão resistente e AOS foram buscados nos seguintes bancos de dados eletrônicos: Cochrane Library; PubMed; ScienceDirect e Web of Science. Os estudos selecionados foram submetidos a avaliação de qualidade, meta-análise e teste de heterogeneidade. Resultados: Foram incluídos na meta-análise seis ensaios clínicos controlados aleatórios. As estimativas combinadas das alterações das médias de pressão arterial sistólica e pressão arterial diastólica (medidas por meio de monitoração ambulatorial da pressão arterial durante 24 h) foram de −5,40 mmHg (IC95%: −9,17 a −1,64; p = 0,001; I2 = 74%) e −3,86 mmHg (IC95%: −6,41 a −1,30; p = 0,00001; I2 = 79%), respectivamente. Conclusões: O tratamento com CPAP é capaz de reduzir significativamente a pressão arterial em pacientes com hipertensão resistente e AOS.

ABSTRACT Objective: To evaluate systematically the effects of continuous positive airway pressure (CPAP) on blood pressure in patients with resistant hypertension and obstructive sleep apnea (OSA). Methods: The Cochrane Library, PubMed, ScienceDirect, and the Web of Science were searched for studies investigating the effects of CPAP on blood pressure in patients with resistant hypertension and OSA. The selected studies underwent quality assessment and meta-analysis, as well as being tested for heterogeneity. Results: Six randomized controlled trials were included in the meta-analysis. The pooled estimates of the changes in mean systolic blood pressure and mean diastolic blood pressure (as assessed by 24-h ambulatory blood pressure monitoring) were −5.40 mmHg (95% CI: −9.17 to −1.64; p = 0.001; I2 = 74%) and −3.86 mmHg (95% CI: −6.41 to −1.30; p = 0.00001; I2 = 79%), respectively. Conclusions: CPAP therapy can significantly reduce blood pressure in patients with resistant hypertension and OSA.