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Objective:To make a new simple respirator and observe the oxygen therapy effect of the respirator on patients with severe and critical coronavirus disease 2019 (COVID-19).Methods:Based on the infectivity and hospital requirements of COVID-19, a new simple respirator was designed by the medical staff of the Department of Anesthesiology of the Second Affiliated Hospital of Nanchang University, which was applied on the 22 patients with severe and critical COVID-19 who needed oxygen therapy admitted to the Cancer Center of Tongji Medical College of Huazhong University of Science and Technology from February 15th to March 15th in 2020. The new simple respirator contained two National Utility Model Patents (a respirator: ZL 2015 2 0410623.6, a fluid switch and oxygen suction device: ZL 2017 2 0873509.6), which was mainly composed of anesthesia mask and filter, L-shaped connecting tube, soft breathing bladder, connecting tube and elastic fixing belt. When in use, the anesthesia mask was fixed to the patient's mouth and nose with elastic straps, the connecting tube was inserted into the oxygen meter interface, the oxygen flow was adjusted to 6-10 L/min, and the L-shaped connecting tube was opened immediately after the soft breathing bag was full. The carbon dioxide and excess oxygen in the body was discharged from exhaust port. The oxygen flow was lowered to 2-3 L/min, the patient's respiratory rate (RR) was observed through the soft breathing bag fluctuations, and the oxygen flow was adjusted at any time. The changes of pulse oxygen saturation (SpO 2), RR and heart rate (HR) before and after application of new simple respirator were observed, and the blood gas test results of part of the patients were collected. Results:Twenty-two patients with severe and critical COVID-19 had significantly higher SpO 2 at 10 minutes after application of the new simple ventilator than before application (0.994±0.007 vs. 0.952±0.017, P < 0.01), and RR was significantly lower than that before application (times/min: 27.59±3.63 vs. 29.64±3.81, P < 0.01); after 1 day of application, each index was further improved. All 13 patients who received blood gas analysis indicated no carbon dioxide accumulation. Conclusions:The new simple respirator can significantly improve the oxygen therapy effect of patients with severe and critical COVID-19. At the same time, 2019 novel coronavirus (2019-nCoV) can be filtered through the filter to reduce the formation of aerosol and protect the medical staff and patients.
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Objective To research the efficiency of short time intermittent veno-venous hemofiltration (SIVVH)on acute respiratory distress syndrome(ARDS). Methods Totally 95 patients suffered ARDS between January 2014 and October 2016 in the emergency intensive care unit(EICU)were divided to SIVVH group(n =37)and control group(n = 58). The SIVVH group received traditional therapy and SIVVH therapy,and control group traditional therapy. Vital signs,oxygenation index,APACHEⅡ scores between two groups before the treat-ment were compared. Vital signs,oxygenation index,APACHEⅡ scores,time of mechanical ventilation,length of stay of EICU and 28 day mortality between two groups after the treatment were compared. Results In two groups,vital signs,oxygenation index and APACHEⅡscores before the treatment showed no significant difference (P > 0.05). In SIVVH group ,heart rate and respiratory frequency on the 24th ,48th ,72nd and 120th hour were descended significantly when compared with those in control group(P < 0.05);body temperature on the 24th and 48th hour were descended obviously when compared with those in control group(P < 0.05);the oxygenation index on the 24th,48th,72nd and 120th hour were raised(P < 0.05);APACHEⅡ scores on the 72nd and 120th hour were lower than those in control group(P<0.05). There were shorter time of mechanical ventilation and length of stay of ICU in SIVVH group when compared with control group(P<0.05),but the 28 day mortality in SIVVH group was not lower when compared with that in control group(P>0.05). Conclusions SIVVH can improve the function of lung in ARDS,decrease the time of mechanical ventilation and the length of stay of ICU,and possible becomes an important adjunctive therapy.
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Objective To research the efficiency of short time intermittent veno-venous hemofiltration (SIVVH)on acute respiratory distress syndrome(ARDS). Methods Totally 95 patients suffered ARDS between January 2014 and October 2016 in the emergency intensive care unit(EICU)were divided to SIVVH group(n =37)and control group(n = 58). The SIVVH group received traditional therapy and SIVVH therapy,and control group traditional therapy. Vital signs,oxygenation index,APACHEⅡ scores between two groups before the treat-ment were compared. Vital signs,oxygenation index,APACHEⅡ scores,time of mechanical ventilation,length of stay of EICU and 28 day mortality between two groups after the treatment were compared. Results In two groups,vital signs,oxygenation index and APACHEⅡscores before the treatment showed no significant difference (P > 0.05). In SIVVH group ,heart rate and respiratory frequency on the 24th ,48th ,72nd and 120th hour were descended significantly when compared with those in control group(P < 0.05);body temperature on the 24th and 48th hour were descended obviously when compared with those in control group(P < 0.05);the oxygenation index on the 24th,48th,72nd and 120th hour were raised(P < 0.05);APACHEⅡ scores on the 72nd and 120th hour were lower than those in control group(P<0.05). There were shorter time of mechanical ventilation and length of stay of ICU in SIVVH group when compared with control group(P<0.05),but the 28 day mortality in SIVVH group was not lower when compared with that in control group(P>0.05). Conclusions SIVVH can improve the function of lung in ARDS,decrease the time of mechanical ventilation and the length of stay of ICU,and possible becomes an important adjunctive therapy.