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Research Article
Post Traumatic Acute Respiratory Distress Syndrome in the Emergency and Critical Care Units of the Douala General Hospital Cameroon
Issue:
Volume 14, Issue 1, June 2026
Pages:
1-6
Received:
14 December 2025
Accepted:
26 December 2025
Published:
23 January 2026
Abstract: Introduction: Acute Respiratory Distress Syndrome (ARDS) is a severe, life-threatening complication of major traumatic injury, contributing significantly to morbidity and mortality in emergency and critical care settings globally. Data on the specific clinical profile and outcomes in Sub-Saharan African trauma centers are scarce. Objective: The Objective was to describe the epidemiology, clinical profile, severity of injury (Injury Severity Score, ISS), surgical management, and therapeutic outcomes of post-traumatic ARDS among adult trauma patients managed at the Emergency and Critical Care Unit (ECCU) of Douala General Hospital (DGH). Materials and methods: the method was a retrospective observational study was conducted over a 24 months period (January 2022 to December 2024) at DGH, including 68 consecutive adult trauma patients who developed ARDS based on the Berlin criteria. Data collected included demographics, mechanism of injury, ISS, associated injuries (especially Thoracic Trauma and Traumatic Brain Injury [TBI]), ASA physical status, intra-operative events, ARDS severity, and final outcomes (survival vs. death). Results: The mean age was 39.8±14.7 years, with a male predominance (79.4%). Severe trauma (ISS ≥25) accounted for 79.4% of the cohort, with a mean ISS of 31.6±11.2. The most frequent injuries were Thoracic Trauma (50.0%) and Long Bone Fractures (42.6%). Early complications included shock (44.1%) and massive hemorrhage (36.8%). Urgent surgeries were performed in 67.6% of operative cases. ARDS onset occurred at a median of 2.8 days post-injury. The overall in-hospital mortality was 32.4%. Independent predictors of mortality included ISS≥35, the presence of shock on admission, and severe TBI. Therefore, post-traumatic ARDS represents a major burden in the DGH ECCU, driven by high-velocity blunt trauma and associated with a significant mortality rate of 32.4%. Conclusion: These findings emphasize the necessity of strict, multidisciplinary protocols focused on prompt hemorrhage control, optimized resuscitation, and early identification of high-risk trauma patterns to improve critical care outcomes.
Abstract: Introduction: Acute Respiratory Distress Syndrome (ARDS) is a severe, life-threatening complication of major traumatic injury, contributing significantly to morbidity and mortality in emergency and critical care settings globally. Data on the specific clinical profile and outcomes in Sub-Saharan African trauma centers are scarce. Objective: The Obj...
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Research Article
Intermittent Ozone Insufflation as an Adjuvant Therapy for Ischemic Ulcers in Lower Extremity Arterial Occlusive Disease: A Prospective Randomized Controlled Study
Issue:
Volume 14, Issue 1, June 2026
Pages:
7-12
Received:
25 December 2025
Accepted:
9 January 2026
Published:
27 January 2026
Abstract: Background: Lower extremity arterial occlusive disease (LEAOD), primarily arteriosclerosis obliterans (ASO), often leads to chronic, refractory ischemic ulcers, posing significant challenges in wound management and carrying high risks of amputation and mortality. This study aimed to evaluate the clinical efficacy and safety of intermittent local ozone insufflation as an adjuvant therapy for promoting wound healing and alleviating pain in patients with ASO-related ischemic ulcers. Methods: In this prospective randomized controlled trial, 62 eligible patients with LEAOD and lower limb ulcers admitted between July 2023 and December 2024 were randomly assigned to either an experimental group (n=32) or a control group (n=30). The control group received standard wound care (debridement, dressing changes), while the experimental group received standard care plus twice-daily local ozone insufflation (50 ml per session, 20 minutes each). Wound pain (Visual Analog Scale, VAS) and wound status (Bates-Jensen Wound Assessment Tool, BWAT) were assessed before intervention and on days 1, 3, and 7 post-intervention. Results: It showed that the experimental group had significantly lower VAS scores than the control group post-intervention (P<0.001). Similarly, BWAT scores in the experimental group were significantly lower (P<0.001), indicating better wound healing. Key healing indicators, including time to granulation tissue formation and time to exudate control, were also significantly shorter in the experimental group (P<0.001). No ozone-related adverse events were observed. Conclusion: Intermittent ozone insufflation is a safe, effective, non-invasive adjuvant therapy that significantly reduces pain and accelerates early wound healing in patients with ischemic ulcers due to LEAOD, offering a valuable clinical strategy for managing these challenging wounds.
Abstract: Background: Lower extremity arterial occlusive disease (LEAOD), primarily arteriosclerosis obliterans (ASO), often leads to chronic, refractory ischemic ulcers, posing significant challenges in wound management and carrying high risks of amputation and mortality. This study aimed to evaluate the clinical efficacy and safety of intermittent local oz...
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Research Article
The Vertical Performance Management Model: An Analysis of Its Impact on Nursing Staff Satisfaction
Issue:
Volume 14, Issue 1, June 2026
Pages:
13-20
Received:
21 January 2026
Accepted:
3 February 2026
Published:
11 February 2026
Abstract: Objective: This study aimed to investigate nurse satisfaction with the performance reform under the nursing department‘s vertical management model. Methods: A performance management model incorporating risk, workload, technical difficulty, and night shift factors was developed and implemented in a tertiary hospital. In November 2024, a hospital-wide survey was conducted at a tertiary hospital using a self-designed questionnaire. Out of 936 questionnaires distributed, 928 valid responses were collected, yielding a high effective response rate of 99.15%. Results: Satisfaction with the reform differed significantly across age, work experience, education, professional title, department type, department grade, and monthly income (P < 0.05). However, the overall satisfaction with the performance system showed significant differences primarily based on department type, department grade, and monthly income level (P < 0.05). Inpatient ward nurses reported higher satisfaction than non-inpatient ward nurses. Nurses in higher-risk departments (grades A and B) expressed greater satisfaction than those in lower-risk departments. Additionally, satisfaction levels rose significantly with higher monthly income. Conclusion: The performance reform under the nursing department vertical management model effectively accounts for job risk and workload. It serves as a positive mechanism to enhance nurse motivation, encourage night shift engagement, and strengthen the nursing department’s managerial function. Further efforts should focus on improving communication and transparency to address gaps in understanding and satisfaction among certain nurse groups.
Abstract: Objective: This study aimed to investigate nurse satisfaction with the performance reform under the nursing department‘s vertical management model. Methods: A performance management model incorporating risk, workload, technical difficulty, and night shift factors was developed and implemented in a tertiary hospital. In November 2024, a hospital-wid...
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Research Article
Value of Left Ventricular Layer-specific Strain in Detecting Left Ventricular Dysfunction in Diabetes Patients with Left Ventricular Remodeling and Non-remodeling
Issue:
Volume 14, Issue 1, June 2026
Pages:
21-30
Received:
1 February 2026
Accepted:
13 February 2026
Published:
26 February 2026
DOI:
10.11648/j.ijacm.20261401.14
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Abstract: To explore the application of left ventricular (LV) stratified strain in evaluating early systolic dysfunction in diabetes patients with and without LV remodeling by using two-dimensional speckle tracking echocardiography (2DSTE), This study included 35 diabetes patients and 25 healthy individuals. All participants completed echography by GE Vivid E9 ultrasound system. The diabetes patients were subdivided based on relative wall thickness into normal LV geometry group and LV remodeling group. The EchoPAC offline workstation was used to analyze LV myocardial longitudinal layer-specific strain. Our results showed that compared to the control group, the absolute values of longitudinal strain in the endocardial, mid-myocardial, and epicardial layers of the 3-chamber view, the epicardial layer of the 4-chamber view, as well as the average longitudinal strain of the mid-myocardial and epicardial layers across all three views, were significantly decreased in the diabetes group (P < 0.05). Compared to the control group, both the normal LV geometry and LV remodeling subgroups showed significantly reduced absolute values of longitudinal strain in the epicardial layer of the 3-chamber and 4-chamber views, and in the average epicardial strain across all three views (P < 0.05), with the most pronounced changes observed in the LV remodeling group. Furthermore, compared to the control group, the LV remodeling subgroup exhibited significantly reduced absolute values of longitudinal strain in the endocardial and mid-myocardial layers of the 3-chamber view, the endocardial layer of the 4-chamber view, and the average mid-myocardial strain across all three views (P < 0.05). A significant decrease in the absolute value of epicardial longitudinal strain in the 3-chamber view was also found in the LV remodeling group compared to the normal LV geometry group (P < 0.05). The study reveals that in diabetes patients with either normal LV geometry or LV remodeling, impairment of epicardial longitudinal strain in the 3-chamber and 4-chamber views, as well as the average epicardial strain, occurs earlier. In diabetes patients with LV remodeling, longitudinal strain in the endocardial and mid-myocardial layers of the 3-chamber view, the endocardial layer of the 4-chamber view, and the average mid-myocardial strain were the most sensitively impaired parameters. Additionally, the impairment of myocardial longitudinal strain was most pronounced in the apical 3-chamber view.
Abstract: To explore the application of left ventricular (LV) stratified strain in evaluating early systolic dysfunction in diabetes patients with and without LV remodeling by using two-dimensional speckle tracking echocardiography (2DSTE), This study included 35 diabetes patients and 25 healthy individuals. All participants completed echography by GE Vivid ...
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Review Article
The Current State of Research on the Impact of Desflurane on Postoperative Delirium
Yong Liu*
Issue:
Volume 14, Issue 1, June 2026
Pages:
31-36
Received:
4 February 2026
Accepted:
20 February 2026
Published:
27 February 2026
DOI:
10.11648/j.ijacm.20261401.15
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Views:
Abstract: Postoperative delirium (POD) is a common and severe postoperative complication, with its incidence in non-cardiac surgical patients ranging from 10% to 60% based on surgical types. POD is generally recognized as a result of the interaction between individual susceptibility and external inducing factors, in which anesthetic modes and drug selection play a crucial role for anesthesiologists. Most studies have indicated that inhalation anesthesia may raise the risk of POD compared with propofol-based intravenous anesthesia, yet such research mainly focuses on sevoflurane, with few exploring the differences among various inhaled anesthetics in relation to POD. Based on existing basic and clinical research, desflurane shows advantages over sevoflurane and isoflurane, as it causes less neuronal damage and milder neuroinflammatory responses, facilitates faster postoperative consciousness recovery, improves awakening quality and shortens extubation time in patients. However, the current evidence on the potential effects of desflurane on POD is insufficient to draw definitive conclusions. This review systematically summarizes the latest basic and clinical research on desflurane and POD, aiming to clarify the potential effects of desflurane on POD and explore its underlying mechanisms. More rigorously designed and precisely evaluated studies are urgently needed to further verify the efficacy of desflurane in POD prevention and provide evidence-based references for the rational selection of inhaled anesthetics in clinical practice.
Abstract: Postoperative delirium (POD) is a common and severe postoperative complication, with its incidence in non-cardiac surgical patients ranging from 10% to 60% based on surgical types. POD is generally recognized as a result of the interaction between individual susceptibility and external inducing factors, in which anesthetic modes and drug selection ...
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