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Objective@#To verify the accuracy of oxygen concentration (FiO2) of modified oxygen treatment with Venturi and humidity system.@*Methods@#Patients just after ventilator weaning and before the removal of tracheal intubation/tracheotomy tube, who admitted to the intensive care unit (ICU) of Henan Provincial People's Hospital from May 1st to December 15th in 2017, were enrolled. All patients were given a modified oxygen treatment with Venturi and humidity system, and the oxygen flow rate (Flow) of the Venturi device and the oretical value of FiO2 were adjusted according to the patient's condition. Patients were divided into five groups based on doctor's orders: Flow 3 L/min FiO2 0.24, Flow 3 L/min FiO2 0.26, Flow 6 L/min FiO2 0.28, Flow 6 L/min FiO2 0.30, Flow 9 L/min FiO2 0.35. The value of FiO2 at the inhalation end of patients of each group was measured by TSI airflow analyzer, and the consistency between the measured value of FiO2 at the inhalation end and the FiO2 marked value of Venturi was compared and analyzed.@*Results@#When the FiO2 theoretical value of Venturi were adjusted to 0.24, 0.26, 0.28, 0.30, and 0.35, the measured values of FiO2 at the inhalation end of patients were 0.38±0.05, 0.38±0.05, 0.40±0.04, 0.41±0.04, and 0.77±0.11, respectively, which were all significantly higher than the theoretical value of FiO2 (all P < 0.01). The difference between the measured value of FiO2 at the inhalation side and the FiO2 value of the Venturi annotated and the difference rate were both "V"-shaped, both of which decreased with the increase in theoretical value of FiO2 to a Flow of 9 L/min and a theoretical value of FiO2 0.35, the accuracy was the worst, with the FiO2 difference of 0.42±0.11, and the FiO2 difference rate of (121.6±36.5)%.@*Conclusion@#There is a difference between the measured value and the theoretical value of FiO2 at the inhalation end of the modified Venturi oxygen therapy humidification system, which needs to be paid attention to during clinical oxygen therapy.
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Objective To monitor ventilator-associated event (VAE) for the first time in an intensive care unit (ICU) in China,understand the applicability,incidence,and clinical significance of VAE in China.Methods Targeted monitoring on VAE was performed among patients ≥18 years and with mechanical ventilation (MV)＞2 days in the ICU of a hospital between January 2014 and September 2015,incidence of VAE was calculated,and patients were grouped according to whether or not they had VAE,prognostic factors were analyzed statistically.Results A total of 1 004 patients were monitored,the total hospital stay was 13 795 days in patients who used ventilator,307 (30.58％) cases of VAE occurred,incidence of VAE per 1 000 ventilator-days was 22.25.Univariate analysis showed that patients with VAE had longer length of ICU stay and MV,and higher mortality rate than patients without VAE when they moved out of ICU (all P＜0.05).Multivariate logistic regression analysis showed that VAE was independent risk factor for length of ICU stay,duration of MV,as well as mortality when patients moved out of ICU(all P＜0.05).Conclusion Judgment of VAE is based on MV parameters,it is more objective and accurate.There is a high incidence of VAE among ICU patients,it may lead to poor clinical outcomes,and has good values for the targeted monitoring on ICU patients in large comprehensive hospitals of China.
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Objective:To compare the personal characteristics between the patients with paradoxical insomnia and the patients with primary insomnia or the normal sleepers.Methods:A case-control study with the proportion at 1∶1∶1 was carried out.The patients with paradoxical insomnia were diagnosed in Sleep Medicine Center of West China Hospital of Sichuan University between March 2013 and December 2013.A case of paradoxical insomnia was matched with two controls:a primary insomnia patient and a normal sleeper.A total of 63 matched cases were collected.A face-to-face survey was conducted by using the following scales:General Data Scale and Eysenck Personality Questionnaire (EPQ).Results:The average scores of psychoticism,extraversion,and neuroticism for paradoxical insomnia cases were (52.1±10.2),(49.6±9.8),and (56.0±12.0),respectively.In general,31.7% of paradoxical insomnia patients had psychoticism or psychoticism tendency in their personality,which were more obvious than those in primary insomnia patients (7.9%) (x2=l 1.228,p0.0125).Conclusion:The personal characteristics for paradoxical insomnia patients did not reached obviously abnormal level.However,their psychoticism tendency,extroversion tendency and neuroticism tendency needed to be paid attention.
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Objective To investigate the incidence of healthcare-associated infection (HAI)in patients in a respiratory in-tensive care unit (RICU)of a teaching hospital,and provide reference for HAI prevention and control.Methods All pa-tients admitted to this RICU from January to December 2014 were surveyed with prospective targeted monitoring method, surveyed data were analyzed statistically.Results A total of 561 patients were surveyed,43 patients developed 44 times HAI,HAI rate and HAI case rate were 7.66% and 7.84% respectively,incidence of HAI and adjusted incidence of HAI per 1 000 patient-days were 6.26‰ and 1.79‰ respectively.The main infection site was urinary tract (45.46%,n=20). Incidence of ventilator-associated pneumonia (VAP ),catheter-related bloodstream infection (CRBSI),and catheter-associat-ed urinary tract infection (CAUTI)per 1 000 catheter-days were 2.73‰(n=13),1.57‰(n=2),and 3.78‰(n=18)re-spectively.Incidence of HAI per 1 000 patient-days between the first and second half year of 2014 was significantly differ-ent(4.59‰ vs 7.89‰;u=-1.75,P =0.04).A total of 47 pathogenic strains were isolated,the main pathogens were gram-negative bacteria(n=26,55.32%).Conclusion The major HAI in RICU is device-associated infection,it is necessary to strengthen the management of invasive procedures;targeted monitoring can find the weak links of infection control prac-tice and helpful for taking effective prevention and control measures to reduce the incidence of HAI in ICU.
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Objective To explore the prevalence and related factors of post-traumatic stress disorder (FTSD) among nurses who took part in rescue of 5.12 Wenchuan earthquake after two years.Methods The PTSD Checklist-Civilian Version (PCL-C) was used to diagnose PTSD among nurses from Mianzhu,one of the city where the earthquake happened.Results Totally 223 subjects finished the evaluation.The incidence rate of PTSD among the nurses was 1.7％(PCL-C＞50),and 8.2％ people had different degree of post-traumatic stress disorder.Comparing the three symptom clusters,hyper-arousal was the most prominent one.Different age,professional position,marriage,health condition significantly influenced the prevalence of PTSD.The risk factors of PTSD was bad health condition and being divorced or widowed.Conclusions The nurses still showed some symptoms of PTSD two years after the earthquake,individualized psychological intervention should be applied to them.