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Objective@#To explore the method of the blood return of continuous blood purification therapy for patients with heart failure.@*Methods@#A total of 69 patients with heart failure treated by continuous blood purification therapy in our ICU from January 2017 to January 2018 were randomly divided into experimental group (blood return with blood bag,35 patients) and the control group (blood return with machine,34 patients). The vital signs, clinical manifestations and hemodynamic indicators of each patient were collected during the blood return of the first CBP therapy, and the data were analyzed between the two groups.@*Results@#After blood return of the first CBP therapy, the exacerbation of New York Heart Association (NYHA) heart function grade, SpO2, CVP, HR of patients in the control group were 33.27% (11/31), 0.91 ± 0.06, (12.44 ± 1.43) cmH2O (1cmH2O=0.098 kPa), (118.17 ± 3.27) times per minute and those in the experimental group were 6.25% (2/32), 0.96±0.04, (8.98±1.36) cmH2O, (90.45 ± 3.35)times per minute, respectively. The difference was statistically significant between the two groups (χ2=3.786, t=2.861, -7.565, 3.792, P< 0.05). Subgroup analysis showed that for patients within 24 hours of CBP treatment, the exacerbation of NYHA heart function grade, SpO2, CVP, HR of the control group and the experimental group were respectively 76.92% (10/13), 0.86±0.01, (12.92±1.12) cmH2O, (111.38±2.96) times per minute and 8.33% (1/12), 0.94±0.01, (8.11±0.74) cmH2O, (90.34±1.32) times per minute, the difference was statistically significant (χ2 =9.345, t=-14.101, 2.894, 7.648, P < 0.05). For patients treated with CBP therapy over 24 hours, the difference of the exacerbation of NYHA heart function grade, SpO2, CVP, HR of the control group and the experimental group was not statistically significant (P>0.05).@*Conclusions@#In patients with heart failure treated with CBP, especially in those treated with CBP therapy within 24 hours, blood return with blood bag may avoid the recurrence of heart failure.
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Objective To conduct the contrastive analysis on the indwelling time of fixing indwelling needle by cutting sterile transparent dressing and non-cutting sterile transparent dressing.Methods A total of 236 inpatients in this hospital from August to December 2016 were selected.The patients with odd at last number of admission number served as the experimental group (119 cases),while the patients with even at the last number of admission number served as the control group(117 cases).The indwelling needle type was 18GA,the puncture was once success and the fluid infusion course was more than 5 d.The experimental group used the cutting sterile transparent dressing for fixing the indwelling needle and the extension tube vas completely exposed to the outside of dressing,while the control group adopted the conventional indwelling needle application fixation mode.The blood returning plugging pipe rate,average indwelling time and phlebitis occurrence at 24,48,72,96,＞ 96 h after indwelling needle were recorded.Results The blood returning plugging tube situation at 48,72,96,＞96 h after indwelling needle in the experimental group was superior to that in the control group,the difference was statistically significant(P＜0.05);the average indwelling time in the experimental group was (72.12 ± 3.25)h,while which in the control group was (59.34--3.78) h,and the difference was statistically significant (P＜0.05).Seven cases of phlebitis occurred in the experimental group and 9 cases in the control group,the difference was not statistically significant(P＞0.05).Conclusion Applying cutting sterile transparent dressing for fixing the indwelling needle reduces the plugging pipe rate due to returning blood coagulation,extends the indwelling needle use time,increase the patient's satisfaction,moreover does not increase the phlebitis occurrence risk.
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ObjectiveTo investigate the effective method of preventing blood return when using nitroglycerin for patients with heart failure. Methods Using physiological saline solution or 5% glucose with nitroglycerin pumped into the same vein for patients at the same time, and then observed the condition of blood returning, recorded the critical drop-speed which can effective prevented blood return. Observed the influence of added solution on heart function of patients with heart failure. Results Pumped physiological saline solution or 5% glucose with nitroglycerin in the same time with the speed of 5ml/h can effective prevent the blood return, and the added solution can not influence the heart function for patients with heart failure significantly. Conclusion Pumped physiological saline solution or 5% glucose with nitroglycerin into the same vein at the same time can effective preventing the blood return, and the added solution can not influence the heart function for patients with heart failure significantly.
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BACKGROUD: The blood component should not be issued for transfusion if there is any abnormality in color or physical appearance, or any indication of contamination. During 3 years (1999-2001), 1,041 blood components were returned to Central Red Cross Blood Center from the hospitals because of various reasons. We Analyzed the frequency and reasons of blood component returns for the useful information of blood supply plan. METHODS: Each blood component return in the Blood Component Return Report from 1999 through 2001 was examined for the number of units and return reasons. RESULTS: For 3 years, the total number of supplied blood components were 1,203,573 units and 1,041 (0.09%) of them were returned from 26 hospitals. The most common reason of return was broken bag or pilot tube (70.9%). Other reasons were fibrin(or precipitates) in bag (3.0%), clots in pilot tube (2.9%), turbid plasma (1.8%), hemolysis (0.5%), icteric plasma (0.3%), label errors (1.1%), incompatible cross matching (0.2%) and others (0.7%). Also there were blood returns due to poor handling of blood components in hospital (1.9%) and reasons unrelated to blood safety, purity and potency such as rare blood (5.8%), exchange for fresh blood (9.8%) and unused blood (1.2%). The most commonly returned blood component was plasma component (69.5% of units) CONCLUSION: The final product should be inspected prior to issue with more strict standard. And the proper system for assurance of returned normal blood components from hospitals must be applied for efficient blood utilization.