Investigation on sedation level and influencing factors in postoperative patients with mechanical ventilation in ICU / 中国实用护理杂志

Objective:To investigate sedation level for postoperative patients with mechanical ventilation in ICU, and to explore the related factors and patient outcomes with different sedation level.Methods:Totally 163 postoperative ICU patients from 11th June to 30th October 2018 were prospectively analyzed. Medical information and all the RASS (Richmond Agitation Sedation Scale) scores was recorded by nurses.Results:The 163 enrolled patients received 11 261.62 hours mechanical ventilation therapy, and 2 815 RASS scores were assessed and recorded by nurses. Among these scores, 80.3% (2 261/2 815) were at light sedation level, while 17.4% (490/2 815) and 2.3% (64/2 815) were at excessive or insufficient sedation level, respectively. All patients were divided into satisfactory sedation group and unsatisfactory sedation group according to the recommendations of guidelines, and used both univariate analysis and multivariate analysis. Compared to males, female patients tend to be in a satisfactory sedation level ( OR value was 0.39, P<0.05); use of midazolam may increase the risk of unsatisfactory sedation level ( OR value was 5.60, P<0.05); the longer sedation assessment interval ( OR value was 1.70, P<0.05), the more likely the patient′s sedation level is unsatisfactory ( OR value was 1.70, P<0.05) . Patients in sedation unsatisfactory group have higher rate of tracheostomy ( χ 2 value was 9.70, P<0.01), longer ICU stay ( U value was -2.33, P<0.05) and more medical expense ( t value was -4.26, P<0.01). Conclusion:The current sedation management in our ICU is satisfactory, but there is still a small part of patients in a state of insufficient sedation or excessive sedation. Sedation level is closely related to sedatives, RASS assessments interval performed by the nurses. This study provides a reference and basis for clinical sedation management and the sedation assessment strategies in the ICU.

Influences and countermeasures of catheter-related bloodstream infections with peripherally inserted central catheters in ICU / 中国实用护理杂志

Objective To analyze the influences of catheter related bloodstream infection(CRBSI) for ICU patients with PICC. Methods Information and documents of 164 PICC patients were collected from October 2014 to December 2016, general information, intravenous drugs and skin conditions were analyzed if they have any impacts on CRBSI. Results Sixteeen patients with CRBSI and 148 patients with non-CRBSI.The acute physiology and chronic health evaluation(APACHEⅡ) score,hospitalization time,PICC catheterization time was(22.25 ± 4.95)points,(99.44 ± 57.34)d, (67.44 ± 48.30)d in CRBSI patients, and (14.64 ± 6.86) points, 21.00(22.00) d, 12.00 (14.00) d in non-CRBSI patients. There were significant differences (U=439.00, 299.00, 383.00, all P<0.01). The incidence of injection of vasoactive drugs and skin edema were accounted for 8/16,10/16 in CRBSI patients,and 25.00%(37/148),31.08%(46/148) in non-CRBSI patients, the difference was statistically significant (χ2=4.53, 6.34, P<0.05). The APACHE II score was an independent risk factor for PICC catheter-related infections(OR=1.21,P<0.01). Conclusions The environment in ICU is quite complicated and patients often have the characteristic of instability, which drives us to evaluate the influence factors of CRBSI and offer guidance for PICC maintenance.These can help reduce the incidence of CRBSI in ICU and improve the quality of patients.

Comparative Evaluation of Hepatoprotective Activities of Geniposide, Crocins and Crocetin by CCl4-Induced liver Injury in Mice

Iridoid glycosides (mainly geniposide) and crocetin derivatives (crocins) are the two major active constituents in Gardenia jasminoides Ellis. In the present study, geniposide, crocins, crocin-1 and crocetin were separated from gardenia chromatographically. Then, mice were orally administrated with geniposide (400 mg/kg b.w.), crocins (400 mg/kg b.w.), crocin-1 (400 mg/kg b.w.) and crocetin (140 mg/kg b.w.) once daily for 7 days with CCl4. Hepatoprotective properties were evaluated by biochemical parameters: Administration of geniposide, crocins, crocin-1and crocetin significantly lowered serum alanine transaminase (ALT), aspartate transaminase (AST) and alkaline phosphatase (ALP) levels in CCl4-treated mice. The reduced glutathione (GSH) levels and antioxidant enzymes (SOD and CAT) activities were also increased by geniposide, crocins, crocin-1 and crocetin. Histopathological examination of livers showed that these components reduced deformability, irregular arrangement and rupture of hepatocyte in CCl4-treated mice. These biochemical results and liver histopathological assessment demonstrated that geniposide, crocetin derivatives and crocetin show comparative beneficial effects on CCl4-induced liver damage via induction of antioxidant defense. Therefore, contents of geniposide and crocetin derivatives should be both considered for hepatoprotective efficacy of Gardenia jasminoides Ellis.

The protective effects of chloride channel blockers on the cultured hippocampal neuronal apoptosis induced by NO in rats / 中国药理学通报

Aim To observe the protective effects of SITS and DIDS,two kinds of chloride channel blockers,on hippocampal neuronal damage induced by NO in culture.Methods The cultures were divided into three groups:control group,NO treatment group,NO treatment plus chloride channel blocker group. The cultures were detected with the methods of morphological stain (Hoechst 33258),and the apoptotic neurons and neuronal viabilities were observed through MTT quantitative analysis. The activated caspase-3 was analyzed with western blot.Results There were significant protective effects of SITS and DIDS on neuronal damage with dose-dependence.Conclusions Chloride channel blockers have some protective effects against neuronal injury induced by NO.