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Objective To analyze the current medical equipment maintenance management model and the existing problems.Methods According to the law of reliability bathtub curve,the maintenance decision of medical equipments was analyzed from the three failure period stages,including early failure period,accidental failure period and loss failure period.By taking breathing machines as an example,a maintenance decision analysis during accidental failures was conducted.Results Medical equipment problems are caused by a variety of reasons,including operational problem,technical problem and management problem.The operational problem is caused by maintenance delays,lack of maintenance,and non-standard operations.The technical problem was caused by a wide variety of medical equipment and complex maintenance manuals.The management problem was caused by lacking of scientific management in equipment maintenance and updates.Conclusions For different stages of medical equipment,the impact factors are different and different maintenance strategies should be selected.
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Objective To develop a humidification fluid dropping joint for the breathing machine to solve the problems in humidification fluid retension,pipeline leakage,pipeline fixation and etc.Methods A Infusion extension tube was involved in with 10 cm length left at the injector end.A hole was made at the side wall of the L-shaped joint of the breathing machine,whose internal diameter equaled to the external diameter of the extension tube.The extension tube was put into the joint through the hole,and the depth of imbedded tube was within 4 and 6 cm.Sealing and fixation at the connection between the tube and hole were executed with 502 glue and short tourniquet.Results The humidification fluid dropping joint could be connected with infusion apparatus of the pump or the infusion extension tube of the micro pump,which behaved well in eliminating accumulated humidification fluid,sputum suction,humidification and facilitating mechanical ventilation.Conclusion The joint developed gains advantages in easy manufacture,reducing complications and increasing the dependence on artificial airway,and thus is worthy promoting clinically.
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Objective To master the current situation of the in-use breathing machine through quality control process so as to improve its safeness in use and accuracy.Methods In accordance with NO.83 Ministry of Health Standard (2008) for Breathing Machine Quality Detection,Swedish ALKPF-300 quality detecting instrument was used to test the tidal volume,breathing rate,inspiratory pressure,concentration of oxygen intake and etc of the breathing machine,and analysis was executed on the detection results from 2013 to 2015.Results The qualification rate was 84.2％,and reached 100％ after maintenance,so that the requirements of clinical departments were met completely.Conclusion The breathing machine has the highest risks in all medical devices,and emphases have to be posed on operating instruction,daily maintenance and quality control to ensure its quality rate.
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Objective To explore the expression and its clinical significance of serum procalcitonin (PCT)level in ventilator-associated pneumonia( VAP)in newborns. Methods One hundred and fifty-five children with suspected VAP in Shajing Hospital of Shenzhen Affiliated to Medical University of Guangzhou from June 2013 to December 2014 who were in intensive care kiunit(NICU)were selected as our subjects. According to whether they had VAP or not could be divided into VAP group(80 cases)and non-VAP group(75 cases). Immunoluminometric method was used to detect PCT level at 1st day. According to the different medicine,VAP group was divided into 40 cases of two groups. The control group was according to the situation of children which was used empirical antibiotic by clinicians. The observation group was given antibiotics according to the level of PCT(the antibiotics were used when PCT > 0. 25 μg/ L). After treatment,if PCT did not decrease,the antibiotics was replaced. If PCT decreased,the antibiotics was continued to use the same kind of antibiotics. While the PCT< 0. 25 μg/ L,the antibiotics were stopped using. The change of the PCT level at 1st,4th,7th,10th day of two groups were observed. Results Serum PCT level of VAP group was(1. 68 ± 0. 83)μg/ L,significantly higher than that of non-VAP((0. 10 ± 0. 02)μg/ L),and there was statistically significant difference( t = 52. 614,P< 0. 05). Clinical effective rate of observation group was 87. 5%(35 / 40),which was higher than that of the control group(80. 0%(32 / 40),P = 2. 067). At 4th,7th and 10th day after treatment,PCT expressions of the observation group were all significantly lower than those of the control group. The medical costs and antibiotic using time were significantly lower than those of the control group((3 525. 8 ± 1 162. 9)yuan vs.(4 706. 7 ± 803. 4),(10. 3 ± 2. 7)d vs.(13. 5 ± 1. 4)d;t = 5. 28,6. 65;P < 0. 05). Conclusion The serum PCT levels of newborns of VAP significantly increase,and monitoring the PCT can guide reasonably the use of antibiotics in clinic.
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Objective To compare the rehabilitation effection between standard aerobic training and combined aerobic train-ing in patients with chronic heart failure.Methods Eligible 27 patients with chronic heart failure were collected and divided into two groups:AT group (standard aerobic training)and ARI group (combined aerobic training).Then two groups underwent differ-ent trainings in 12 weeks respectively.Various indexs such as PImax,QME,QMTpeak ,1RM,exercise time,MLwHFQ,and Borg Scale was analyzed before and after the training.Results QMTpeak ,IRM,QME,PImax and SPImax in ARI group were better than those in AT group(P <0.05).And all these index of ARI group also developed compared with before the training(P <0.05),while in AT group,only QME and PImax changed(P <0.05).Both group′s Peak VO2 ,excrcise time,VT increased significantly,and VE/VCO2 slope、SBPpeak and CP of them improved.Compared with AT group,the exercise time of ARI group was longer(P =0.01 ). The echocardiographic parameters of ARI group improved after training(P <0.05),while only LVEF and LVESD had significant different in AT group(P <0.05).MLwHFQ,Brog scale score of ARI group were better than those in AT group.And only MLwH-FQ NYHA in ARI group improved after training(P <0.05).Conclusion The strength of the upper limb and respiratory muscle cardiopulmonary function,and quality of life have been improved markedly in ARI group.
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Objective To explore the curative effect of breathing machine in the treatment of acute heart failure complicated with respiratory failure.Methods 1 1 0 patients with acute heart failure and respiratory failure in emergency ICU of our hospital were selected,they were randomly divided into control group and observation group.The control group received routine therapy,the observation group was given breathing machine on the basis of routine therapy.The treatment efficacy of the two groups was compared.Results Before treatment,PaO2 ,PaCO2 ,PH and SaO2 between the two groups had no obvious differences (P >0.05 ).After treatment,PaO2 ,PH and SaO2 in the observation group were (1 1 .41 ±2.25)kPa,(7.42 ±0.1 9),(97.1 1 ±2.1 7)%,which were significantly higher than those in the control group,PaCO2 was (5.21 ±0.22)kPa,which was significantly lower than the that of the control group,the differences were statistically significant (t =2.501 ,P =0.01 4;t =2.598,P =0.01 1 ;t =2.855,P =0.005;t =-2.691 ,P =0.008).The level of sernm brain natriuretie peptide of the observation group[(472.32 ± 298.06)pg/L]was significantly lower than that of the control group,the difference was statistically significant(t =-2.263,P <0.05).Conclusion The clinical effect of breathing machine EICU in treatment of acute heart failure complicated with respiratory failure is remarkable,and can effectively improve the clinical symptoms,and is worth further clinical application.
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Objective:To study on the best replacement time of breathing humidification pot liquid in mechanical ventilation.Methods:33 mechanical ventilation patients were randomly divided into observation group and control group,in the observation group the humidification pot liquid were replaced 7 days,while in a control group were replaced every day,all liquid samples were cultured for bacteria.Results:119 samples collected in observation group have 3 cases with positive bacterial growth(2.5%),while 112 samples collected in control group have 15 cases with positive bacterial growth(13.4%).Conclusion:Replace humidification pot liquid of breathing machine everyday may cause bacterial pollution more easily than they were replaced in 7 days interval.