The effective application of ventilation at prone position on patients with severe acute respiratory distress syndrome at high altitude / 中国实用护理杂志

Objective To explore the effective application of ventilation at prone position on patients with severe acute respiratory distress syndrome(ARDS) at high altitude. Methods A total of 19 severe ARDS patients in ICU of Qinghai Province People's Hospital were enrolled from February in 2016 to February. in 2018, all of them ventilated at the prone position, several indicators were assessed:heart rate (HR), respiratory (R), mean arterial pressure (MAP); blood gas indicators: arterial oxygen partial pressure (PaO2), inhaled oxygen concentration (FiO2), carbon dioxide partial pressure (PaCO2), blood oxygen saturation (SpO2), oxygenation index (PaO2/FiO2), PH, lung compliance, PEEP and so on, which assessed before and 12h, 24h, 48h, 72h after the ventilation. Results FiO2 and PEEP significantly declined at 12 h, 24 h, 48 h, 72 h after ventilation at the prone position. HR, MAP, R, PaO2, PaCO2, SPO2, PaO2/FiO2, pH and lung compliance significantly improved (F=32.30,24.73, P<0.05). Conclusions It was an effective method for ARDS patients to improve the oxygenation status and vital signs at the plateau with ventilation used at the prone position and probably nursing intervention, which have clinical application value.

Clinical study of modified prone position in reducing the incidence of pressure injury in patients with prone position ventilation / 中国实用护理杂志

Objective To study the effect of using modified prone position to reduce the occurrence of pressure injury in patients with prone position ventilation. Method Totally 64 patients with prone position ventilation from February 2014 to February 2018 were selected in the Department of Intensive Care of the Drum Tower Hospital, Medical College of Nanjing University. Twenty-six patients with prone position ventilation From February 2014 to February 2016 were selected as the control group. The patients in the control group were in a horizontal prone position, with soft pillows under both sides of the shoulders and hips along the longitudinal axis of the patient (vertical axis), and gel pads under chests;Thirty-eight patients with prone position ventilation from March 2016 to February 2018 were selected as the experimental group. The patients in the experimental group were positioned on turnover sliding cloth, soft pillows were placed under the sliding cloth, on one side along the vertical axis (vertical axis) of the patients, and the soft pillows were repositioned to other side of the patients every 4 hours, i.e. the patients were turned over in the prone position. The incidence of pressure injury, the number of occurrences (each site marked as 1) and the incidence of other related complications were compared between the two groups. Results The incidence of pressure injury in the experimental group was 10.53% (4/38) and 46.15% (12/26), in the control group. The median and quartile of the number of pressure injuries in the experimental group were 0 (0,0), and 0 (0,2) in the control group. Statistical analysis was performed using the rank sum test. The difference was statistically significant (F=10.287,11.469, P<0.05). Among other related complications, the unplanned extubation rate was 0.38% (1/26) in the control group and 0 in the experimental group. No aspiration occurred in both groups. Conclusions The use of a modified prone position can reduce the incidence of pressure injuries and reduce the incidence of other related complications, by reducing the duration of skin pressure and decreasing the friction and shear force. It is worthy of popularization and application in clinical practice.

The effective application of ventilation at prone position on patients with severe acute respiratory distress syndrome at high altitude / 中国实用护理杂志

Objective@#To explore the effective application of ventilation at prone position on patients with severe acute respiratory distress syndrome(ARDS) at high altitude.@*Methods@#A total of 19 severe ARDS patients in ICU of Qinghai Province People's Hospital were enrolled from February in 2016 to February. in 2018, all of them ventilated at the prone position, several indicators were assessed:heart rate (HR), respiratory (R), mean arterial pressure (MAP); blood gas indicators: arterial oxygen partial pressure (PaO2), inhaled oxygen concentration (FiO2), carbon dioxide partial pressure (PaCO2), blood oxygen saturation (SpO2), oxygenation index (PaO2/FiO2), PH, lung compliance, PEEP and so on, which assessed before and 12h, 24h, 48h, 72h after the ventilation.@*Results@#FiO2 and PEEP significantly declined at 12 h, 24 h, 48 h, 72 h after ventilation at the prone position. HR, MAP, R, PaO2, PaCO2, SPO2, PaO2/FiO2, pH and lung compliance significantly improved (F=32.30,24.73, P < 0.05).@*Conclusions@#It was an effective method for ARDS patients to improve the oxygenation status and vital signs at the plateau with ventilation used at the prone position and probably nursing intervention, which have clinical application value.

Clinical study of modified prone position in reducing the incidence of pressure injury in patients with prone position ventilation / 中国实用护理杂志

Objective@#To study the effect of using modified prone position to reduce the occurrence of pressure injury in patients with prone position ventilation.@*Method@#Totally 64 patients with prone position ventilation from February 2014 to February 2018 were selected in the Department of Intensive Care of the Drum Tower Hospital, Medical College of Nanjing University. Twenty-six patients with prone position ventilation From February 2014 to February 2016 were selected as the control group. The patients in the control group were in a horizontal prone position, with soft pillows under both sides of the shoulders and hips along the longitudinal axis of the patient (vertical axis), and gel pads under chests; Thirty-eight patients with prone position ventilation from March 2016 to February 2018 were selected as the experimental group. The patients in the experimental group were positioned on turnover sliding cloth, soft pillows were placed under the sliding cloth, on one side along the vertical axis (vertical axis) of the patients, and the soft pillows were repositioned to other side of the patients every 4 hours, i.e. the patients were turned over in the prone position. The incidence of pressure injury, the number of occurrences (each site marked as 1) and the incidence of other related complications were compared between the two groups.@*Results@#The incidence of pressure injury in the experimental group was 10.53% (4/38) and 46.15% (12/26), in the control group. The median and quartile of the number of pressure injuries in the experimental group were 0 (0,0), and 0 (0,2) in the control group. Statistical analysis was performed using the rank sum test. The difference was statistically significant (F=10.287,11.469, P<0.05). Among other related complications, the unplanned extubation rate was 0.38%(1/26) in the control group and 0 in the experimental group. No aspiration occurred in both groups.@*Conclusions@#The use of a modified prone position can reduce the incidence of pressure injuries and reduce the incidence of other related complications, by reducing the duration of skin pressure and decreasing the friction and shear force. It is worthy of popularization and application in clinical practice.