ABSTRACT
BACKGROUND: Because the continuity and integrity of the trachea are likely damaged to some extent after tracheostomy, the implementation of sequential ventilation has certain difficulties, and sequential invasive-noninvasive ventilation on patients after tracheostomy is less common in practice. The present study aimed to investigate the feasibility of invasive-noninvasive sequential weaning strategy in patients after tracheostomy. METHODS: Fifty patients including 24 patients with withdrawal of mechanical ventilation (conventional group) and 26 patients with sequential invasive-noninvasive weaning by directly plugging of tracheostomy (sequential group) were analyzed retrospectively after appearance of pulmonary infection control (PIC) window. The analysis of arterial blood gases, ventilator-associated pneumonia (VAP) incidence, the total duration of mechanical ventilation, the success rate of weaning and total cost of hospitalization were compared between the two groups. RESULTS: Arterial blood gas analysis showed that the sequential weaning group was better than the conventional weaning group 1 and 24 hours after invasive ventilation. The VAP incidence was lowered, the duration of mechanical ventilation shortened, the success rate of weaning increased, and the total cost of hospitalization decreased. CONCLUSION: Sequential invasive-noninvasive ventilator weaning is feasible in patients after tracheostomy.
ABSTRACT
<p><b>OBJECTIVE</b>To study the incidence and the risk factors of dysphagia after ischemic stroke in Chengdu City, China.</p><p><b>METHODS</b>Review was made with unified questionnaire on dysphagia after ischemic stroke in 563 patients from four hospitals, from January to December 2005. Over 20 risk factors related to dysphagia after ischemic stroke were analyzed by logistic regression.</p><p><b>RESULTS</b>The total incidence of dysphagia after ischemic stroke was 13.3% in Chengdu. Data from logistic regression analysis indicated that gender, morbidity frequency, basal nuclei, periventricular lesion, hypertension, pneumonia, hyperlipemia, cervical spondylosisi, internal carotid artherosclerosis were closely related to dysphagia after ischemic stroke,with OR values as 0.416, 0.489, 0.327, 0.454, 2.187, 2.146, 0.352, 0.242 and 0.273 respectively.</p><p><b>CONCLUSION</b>The total incidence was lower than literature published from home and abroad. Gender, morbidity frequency, basal nuclei, periventricular lesion, hypertension, pneumonia, hyperlipemia, cervical spondylosisi and internal carotid artherosclerosis seemed to be risk factors to dysphagia after ischemic stroke.</p>