Browsing by Author "Hung, Tzu-Yao"

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Association between Chronic Kidney Disease and Risk of Cataract: A Nationwide Retrospective Cohort Study
(2017-01-01)
Liu, Yin-Tzu
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Hung, Tzu-Yao
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Lee, Yi-Kung
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Huang, Ming-Yuan
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Hsu, Chen-Yang
Background: Previous studies have established a relationship between chronic kidney disease (CKD) and cataract, but the relationship between the severity of renal impairment and risk of cataract is uncertain. This study investigates the relationship between the severity of renal disease and cataract in a nationwide sample from Taiwan. Methods: The cohort from 1-million National Health Insurance beneficiaries from Taiwan was retrospectively analyzed. All adult beneficiaries were followed from January 1, 2005 until December 31, 2013, to identify patients who underwent cataract surgeries. On the basis of the ambulatory care records, those diagnosed with CKD (ICD-9-CM code: 585) during the follow-up period were enrolled as CKD patients after careful evaluation. Each patient with CKD was age-and gender-matched with 4 individuals who did not have CKD. Cox regression models were applied to compare the hazard of cataract surgery in individuals with and without CKD. Subgroup analysis was used to compare patients with end-stage renal disease (ESRD) with age-and gender-matched non-CKD individuals. ESRD was defined by CKD patients who need regular renal replacement therapy. The same method was applied to evaluate hazard ratios (HRs). Results: After age and gender matching, there were 11,881 patients in the CKD group and 47,524 in the non-CKD group. After control for possible confounding, the adjusted HR (aHR) of cataract was 1.84 (95% CI 1.73-1.95) for the CKD group. Subgroup analysis of patients with ESRD (n = 3,209) and non-CKD individuals (n = 12,836), with matching done on the basis of age and gender, indicated an aHR of cataract was 2.33 (95% CI 2.10-2.59) for the ESRD group. Conclusions: This study indicates a relationship between CKD and cataract, and suggests that the risk for cataract increases with the severity of renal impairment. (C) 2017 S. Karger AG, Basel
Lifting of epiglottis superior to preloaded bougie technique when only the epiglottis is visible: a randomized, cross-over simulated mannequin study
(2020-04-01)
Hung, Tzu-Yao
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Lin, Chieh-Hung
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Lin, Li-Wei
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Yeh, Yu-Hang
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Chen, Wei-Lun
Swivel-HEPA-ETT (SHE) bougie and HEPA-ETT (HE) methods for safe intubation while managing patients with COVID-19
(2020-05-01)
Lin, Li-Wei
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Hung, Tzu-Yao
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交大名義發表
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National Chiao Tung University
The evaluation of a better intubation strategy when only the epiglottis is visible: a randomized, cross-over mannequin study
(2019-01-10)
Hung, Tzu-Yao
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Lin, Li-Wei
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Yeh, Yu-Hang
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Su, Yung-Cheng
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Lin, Chieh-Hung
BackgroundThe Cormack-Lehane (C-L) grade III airway is considered to be a challenging airway to intubate and is associated with a poor intubation success rate. The purpose of this study was to investigate whether the holding position, shapes, bend angles of the endotracheal tube (ET) and the stylet-assisted lifting of the epiglottis could improve the success rate of intubation.MethodsThirty-two participants, 26 physicians, 2 residents, and 4 nurse practitioners, with 12.095.38years of work experience in the emergency department and more than 150 annual intubation events, were enrolled in this randomized, cross-over mannequin study. We investigated the effects of straight-to-cuff ET shapes with 35 degrees and 50 degrees bend angles, banana-shaped ET with longitudinal distances of 28cm and 26cm, two methods of holding the ET (either on the top or in the middle), and lifting or not the epiglottis, on the intubation duration, its success rate, and its subjective difficulty. The aim of the study is to provide optimized intubation strategies for difficult airway with C-L IIb or III grades, when the inlet of the trachea cannot be visualized.ResultsThe two groups that lifted the epiglottis using the stylets, in bend angles of 35 degrees and 50 degrees, had the shortest duration of intubation (23.7514.24s and 20.72 +/- 6.90s, hazard ratios 1.54 and 1.85 with 95% confidence intervals [95% CI] of 1.01-2.34 and 1.23-2.78, respectively) and a 100% success rate in intubations. In the survival analysis, lifting of the epiglottis was the only significant factor (p<0.0001, 95% CI 1.34-2.11) associated with the success rate of intubation.ConclusionsThe use of the epiglottic lift as an adjunctive technique can facilitate the intubation and improve its success rate without increasing procedure difficulty, in C-L III airway, when only the epiglottis is seen.Trial registration ClinicalTrials Registry (https://clincaltrials.gov, identifier NCT03366311).