ABSTRACT
OBJECTIVE:To evaluate the efficacy and safety of the application of airway secretions expurgation cluster manage-ment in oxygen-driven aerosol inhalation. METHODS:280 patients with chronic obstructive pulmonary disease in the Respiratory Second Division of our hospital from Mar. 2012 to Dec. 2013 were randomly divided into group A,B,C and D,with 70 cases in each group.Group A and B were treated with compound isopropyl bromide 2 ml+nomal saline 5 ml,10 min/time,twice a day,and 6 L/min oxygen-driven aerosol inhalation for 7 days;group C and Dreceived Ambroxol hydrochloride injection 15 ml+normal saline 5 ml,10 min/time,twice a day,and 6 L/min oxygen-driven aerosol inhalatiom for 7 days. group A and C were treatment groups, group B and D were control groups. Two treatment groups inhaled compound medications while the application of airway secretions expurgation cluster management. Two control groups inhaled compound medications with single effective cough guidance. RE-SULTS:Compared with control groups,the patients in treatment groups eliminated more phlegm,had lower (PaCO2)and higher (PaO2),also had a shorter hospitalization period,with significant difference(P<0.05). CONCLUSIONS:Airway secretions expur-gation cluster management technology is a simple,safe and effective method,especially in patients with chronic obstructive pulmo-nary disease in oxygen-driven inhalation therapy.
ABSTRACT
Objecfive To investigate the association between bacteriology of airway secretions in acute onset chronic respiratory failure (ACRF) and its clinical prognosis.Methods The bacterial flora and antibiotic resistance in the airway secretions from 44 patients with 49 cases of ACRF were studied,the associations between bacteriology,antibiotic resistance and annual ACRF hospital admission frequency (ACRF≥2 or ACRF<2),its mortality were also explored.Results Positive rate of culture in airway secretions was 63.3%.Untraditional pathogens such as Pseudomonas Aeruginosa accounted for 80.7%.The bacterial yield of patients with ACRF≥2 was twice as that with ACRF<2 (P<0.01).Of the identified bacteria,61.3% displayed antibioticresistance,and there was signifi-cant prolongation of ventilation and hospitalization and increase of mortality in patients with antibiotic resistance(P<0.05).Conclusion There is a predominance of untraditional pathogens such as Pseudomonas Aeruginosa in bacteria from airway secretions of ACRF patients,positive yield and percentage of untraditional pathogens increased with the severity of chronic respiratory failure,infections caused by antibiotic-resistant strains led to higher mortality in ACRF.
ABSTRACT
Intrapulmonary percussive ventilation(IPV), developed by Forrest M. Bird, M.D., delivers high flow mini-bursts of air along with bronchodilator to the lung at a rate of more than 200 times per minute and has the theoretical potential for aiding in expectoration of secretions through internal percussion. To evaluate effects of IPV on respiratory therapy, we compared IPV with conventional chest physical therapy in patients with excess or retained pulmonary secretions. The results are follows. 1) There were no significant differences among the experimental group with respect to blood pressure, heart rate and respiratory rate. 2) Arterial oxygen tension was significantly increased after IPV. 3) ICU stay was slightly shortened in the experimental group as compared with that in the control group. However, there was no statistical significance. These results indicate that IPV may be effective in respiratory care of patients with excess or retained airway secretions.