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Objective To explore the effects of two methods of air-impact on clearing the subglottic secretion in patients with intubation.Methods A simple random sampling method was used to select 106 patients underwent mechanical ventilation through oral tracheal intubation in intensive medicine department from September 2016 to October 2017.The recruited patients were divided into two groups by the random number table,53 patients in Group A were treated with breath-holding key of a ventilator,combined with air-bag inflation and deflation,and 53 patients in Group B were treated with simple breathing apparatus combined with manual technique to clear subglottic secretion.The incidence of ventilator-associated pneumonia(VAP),amount of cleared subglottic secretions,difference of vital signs before and after operation,number of coughing,in vitro training time and operation time were compared between groups.Results The intention-to-treat ana]ysis(ITT) showed that the incidence of VAP in Group A and B were 7.55％ and 5.66％,the per-protocol analysis(PP) showed that the incidence of VAP in Group A and B were 3.92％ and 3.85％,and there was no significant difference between groups(P＞0.05);the amount of cleared subglottic secretions in two groups were (8.31±0.82) ml,(7.97±1.12)ml,and there was no significant difference (P＞ 0.05);but vital signs before and after operation,number of coughing,in vitro training time and operation time in Group A were lower than those in Group B,and the differences were statistically significant(P＜0.05).Conclusion Two methods of air-impact can both effectively reduce the incidence of VAP,but using breath-holding key of a ventilator combined with airbag inflation and deflation has less influence on vital signs,which patients can better tolerate and medical staff can master and cooperate more easily.
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Objective To evaluate effect of preventing ventilator associated pneumoia (VAP) of patients with oral cavity endotracheal intubation by air impulse clearing away secretion drainage. Methods 348 patients with oral trachea cannula and mechanical ventilation (MV) in intensive care unit (ICU) were divided into control group (n=174) and observational group (n=174). The control group adopted conventional airway management methods without the subglottic secretion drainage while the observational group adopted conventional airway management methods on the basis of combining air impact method remove stranded on airbags. Other treatment and care for all of patients were basically the same. The MV time, duration in ICU and incident rate on VAP were compared between the two groups. Results The average of MV time in control group was (5.25±1.18) days, (5.62±3.20) days in ICU and the rate of VAP was 10.34%(18/174). In observational, it was (8.96 ±5.43) days, (10.43 ±4.96 ) days and 34.48%(60/174), respectively. The MV time, duration in ICU and incident rate on VAP were significantly different (P<0.05), with statistical significance. Conclusions The air impact method to remove airbags retentate could shorten time of MV and during time in ICU, and could reduce the rate of VAP.
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Objective To explore the effect of air impact method clearing out the subballonet secretion on the prevention of ventilator-associated pneumonia(VAP) for ventilation patients.Methods 108 cases from ICU who received mechanical ventilation were selected.Patients were divided into the observation group and control group according to odd and even numbers,54 cases in each group.The control group was received conventional airway management,and the observation group received air impact method on the basis of conventional management Results of blood gas analysis,vital signs,occurrence time of VAP,total incidence of VAP,mortality,OB,positive results during mechanical ventilation were observed.Results Occurrence time of VAP for observation group and control group respectively were (14.1 ± 5.2) d and (8.9 ± 3.8) d.VAP incidence in 1 week for observation group and control group respectively were 7.4% (4/54) and 27.8% (15/54).Test positive result of secretion OB for observation group and control group respectively were 16.7% (9/54) and 3.7% (2/54).Total Incidence of VAP for observation group and control group respectively were 33.3% and 37.0%.Differences of occurrence time of VAP,VAP incidence in 1 week and test positive result of secretion OB for two groups were statistically significant (t =5.933,x2 =7.728,4.960,all P ＜ 0.05).Differences of results of blood gas analysis,vital signs,total incidence of VAP,mortality for two groups had not statistically significant.Conclusion Air impact method cleating out the subballonet secretion is simple and safe.Occurrence time of VAP was delayed.Incidence of VAP in one week decreases.,which creates opportunity for rescuing patients.