ABSTRACT
Objective:To investigate of optimal flow oxygen-driven aerosol inhalation of budesonide in patients with acute exacerbation of chronic obstructive pulmonary disease, to provides a reference for improving the atomization effect.Methods:Totally, ninety-six patients with acute exacerbation of chronic obstructive pulmonary disease in Guangzhou Red Cross Hospital from June 2019 to December 2020 were collected and assigned to the low flow group, middle flow group and high flow group according to the random number table method, with 32 cases in each group. All patients received oxygen-driven aerosol inhalation of budesonide therapy, the oxygen flow were 4 L/min, 6 L/min and 8 L/min in the three groups, respectively. Before and after 7 days of treatment, the indices including respiratory dynamics, pulmonary function and blood gas analysis were compared among the three groups.Results:There was no significant difference in the indices including respiratory dynamics, pulmonary function and blood gas analysis before treatment among the three groups( P>0.05). After 7 days of treatment, the peak airway pressure, plateau airway pressure, inspiratory resistance were (22.53 ± 3.83) cmH 2O(1 cmH 2O=0.098 kPa), (15.97 ± 3.01) cmH 2O, (23.25 ± 2.92) cmH 2O·L -1·s -1 in the middle flow group, lower than those in the low flow group (26.09 ± 3.04) cmH 2O, (18.13 ± 2.54) cmH 2O, (26.31 ± 3.65) cmH 2O·L -1·s -1 and high flow group (26.13 ± 3.28) cmH 2O, (17.44 ± 2.02) cmH 2O, (25.06 ± 3.56) cmH 2O·L -1·s -1, the pulmonary dynamic compliance was (33.16 ± 4.43) ml/cmH 2O in the middle flow group, higher than that in the low flow group and high flow group (29.84 ± 3.73), (30.47 ± 3.53) ml/cmH 2O, the differences were statistically significant ( F values were 5.96-11.82, all P<0.05). The FEV 1, FEV 1/FVC, ratio of FEV 1 to estimated vital capacity were (1.36 ± 0.26) L, (49.91 ± 5.94)%, (44.81 ± 5.53)% in the middle flow group, higher than those in the low flow group and high flow group (1.23 ± 0.19) L, (45.22 ± 6.56)%, (40.88 ± 5.97)% and (1.20 ± 0.18) L, (46.41 ± 5.30)%, (41.78 ± 6.32)%, the differences were statistically significant ( F=4.91, 5.36, 3.84, all P<0.05). The PaO 2, oxygenation index were (73.06 ± 7.24), (176.18 ± 17.62) mmHg(1 mmHg=0.133 kPa) in the middle flow group, higher than those in the low flow group and high flow group (67.16 ± 5.10), (164.54 ± 12.34) mmHg and (69.44 ± 7.10), (167.07 ± 16.24) mmHg, PaCO 2 was (52.75 ± 6.22) mmHg in the middle flow group, lower than that in the low flow group and high flow group(57.97 ± 6.75), (56.31 ± 6.45) mmHg, the differences were statistically significant ( F=6.61, 4.96, 5.42, all P<0.05). Conclusions:Oxygen-driven aerosol inhalation of budesonide for acute exacerbation of chronic obstructive pulmonary disease patients, oxygen flow are 6 L/min can effectively improve the indices of respiratory dynamics and blood gas analysis as well as improve pulmonary function.
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Objective To explore the efficacy of fluconazole mouthwash by means of oxygen-driven atomizing inhalation for treating the pediatric oral fungal infections. Methods A total of 60 cases of child patient from the department of Pediatrics of Jiaozhou People's Hospital have been selected and divided into control group and test group with 30 cases for each group by the method of random number table. The sodium bicarbonate solutions as well as the fluconazole capsules were used for the two groups of children patients. Everyday there were five doses of sodium bicarbonate solution as follows:one after getting up in the morning, one after breakfast/lunch/dinner, and one before bedtime by gargling for three minutes followed by spitting. Daily dose of fluconazole capsules was 3 mg/kg, with 50 ml of NS added for preparing a solution of 1-3 mg/ml. Differences between the two groups are as follows. The control group used the traditional method of gargling. The prepared fluconazole solution was divided into five doses for gargling followed by swallowing which were carried out two hours after the sodium bicarbonate solution. The test group used the oxygen-driven atomizing inhalation therapy. The intervals with the sodium bicarbonate solution were two hours. Before the oxygen-driven atomizing inhalation therapy, the children patients had gargled with water to remove the food debris inside the mouth. Next, the daily dose was divided into five doses to be added into the nebulizers for carrying out the oxygen-driven atomizing inhalation therapy focusing on the exposed ulcer areas. The difference in healing time of oral fungal infection of different position and degree between both groups of child patient has been observed. Results The healing time of oral mucositis at different position of both groups has been compared with each other, with the exception of gingival position, the healing time of child patients in test group at the position of cheek, palate, tongue, pharynx, lips and so on was respectively (6.67±1.68) d, (6.38±1.80) d, (6.36±1.96) d, (6.50±1.60) d and (5.00±0.82) d, which were all better than that of the control group, which was (8.13 ± 2.13) d,(8.00 ± 2.14) d,(8.23 ± 2.13) d, (8.67 ± 1.75) d and (7.20 ± 1.48) d, the difference between both groups was statistically significant(t=2.14-2.64, P<0.05);the healing time of child patients in test group with a degree ranging from I to IV was respectively (5.10±0.88) d, (7.92±1.32) d,(8.00±1.00 )d and (10.25±0.96)d,which were all better than that of the control group, which was(6.36±0.81)d,(9.00±1.29) d,(10.33 ± 0.58)d and(12.33 ± 0.58)d,the difference between both groups was statistically significant(t=2.10-3.50,P<0.05). Conclusions It's suitable for oral care of children patients if we replace the fluconazole mouthwash with the oxygen-driven atomizing inhalation therapy which can reduce the severity of oral mucositis and shorten the healing time.
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.