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Objective:To investigate the therapeutic effect of high-flow nasal cannula oxygen therapy (HFNC) and non-invasive positive pressure ventilation (NPPV) on patients with pulmonary edema caused by seawater drowning.Methods:A retrospective analysis method was used. Based on the Utstein database of emergency drowning in the First Hospital of Qinhuangdao, the clinical data of patients with seawater drowning pulmonary edema admitted to the emergency medicine department of the First Hospital of Qinhuangdao from January 1, 2019 to December 31, 2022 were collected. The patients were divided into NPPV group and HFNC group according to different ventilation methods. The general data, endotracheal intubation rate in 7 days, arterial blood gas analysis indexes [arterial partial pressure of oxygen (PaO 2), arterial partial pressure of carbon dioxide (PaCO 2), arterial oxygen saturation (SaO 2)] and hemodynamic indexes (systolic blood pressure, diastolic blood pressure, mean arterial pressure, heart rate, blood lactic acid) before and after treatment, length of stay in intensive care unit (ICU), oxygen therapy comfort of the two groups were compared. Results:A total of 54 patients were enrolled, including 21 patients in the NPPV group and 33 patients in the HFNC group. There were no significant differences in gender, age, state of consciousness and other general information between the two groups. Compared with NPPV group, the rate of endotracheal intubation in HFNC group within 7 days was significantly lower [24.2% (8/33) vs. 33.3% (7/21), P < 0.05]. Before treatment, there were no significant differences in arterial blood gas analysis and hemodynamics between the two groups. After treatment, the above indexes in both groups were significantly improved compared with those before treatment, and PaO 2, SaO 2, systolic blood pressure, diastolic blood pressure and mean arterial pressure in HFNC group were significantly higher than those in NPPV group [PaO 2 (mmHg, 1 mmHg≈0.133kPa): 93.56±6.37 vs. 82.14±6.25, SaO 2: 1.02±0.09 vs. 0.95±0.11, systolic blood pressure (mmHg): 117.37±8.43 vs. 110.42±8.38, diastolic blood pressure (mmHg): 79.43±7.61 vs. 72.21±4.32, mean arterial pressure (mmHg): 92.34±6.32 vs. 85.12±5.38], PaCO 2, heart rate and blood lactic acid were significantly lower than those in NPPV group [PaCO 2 (mmHg) : 34.26±5.63 vs. 37.24±6.22, heart rate (times/min): 73.38±7.56 vs. 86.25±5.41, blood lactic acid (mmol/L): 1.38±0.36 vs. 2.25±1.14], and the differences were statistically significant (all P < 0.05). In addition, the length of ICU stay in HFNC group was significantly shorter than that in NPPV group (days: 13.30±2.38 vs. 16.27±4.26), and the comfort rate of oxygen therapy was significantly higher than that in NPPV group [66.7% (22/33) vs. 42.8% (9/21)], with statistical significance (all P < 0.05). Conclusion:HFNC can improve the oxygenation of patients with pulmonary edema caused by seawater drowning, improve hemodynamics, reduce the rate of tracheal intubation, shorten the length of ICU stay, and improve the comfort of oxygen therapy, which has certain clinical application value.
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It is hard to deal with traumatic brain injury combined with seawater insult and its high motility.Findings have been made in recent preclinical and clinical researches into the traumatic brain injury combined with seawater insult,but further studies are needed because the mechanisms associated with the injury are not completely figured out.This paper summarizes the current basic and clinical researches into the injury,intending to find clues to improve the practical treatment and to guide oncoming studies of the injury.
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Objective To observe the effect of partial liquid ventilation (PLV) and conventional mechanical ventilation(CMV) on gas exchange in lung injury due to pulmonary edema as a result of seawater drowning in rabbit. Methods Twenty-four healthy male new Zealand rabbits were randomly divided into three groups ( n =8). Pulmonary edema was produced in all rabbits by drowning in sea water. Rabbits of PE group received no treatment,that of CMV group were treated with conventional mechanical ventilation and PEEP,and that of PLV group with CMV,combined with PEEP and FDC. All rabbits were treated for 3 hours. Blood gases,TNF-?in plasma and pulmonary histopathology were determined during the experiment. Results In PLV group,PaO_2 was increased obviously,inflammatory exudate was reduced,and alveolar and interstitial edema was alleviated. The plasma level of TNF-?was significantly lower in PLA group compared with PE group,( P
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Objective:To observe the effect of partial liquid ventilation (PLV) on gas exchange,pulmonary compliance and blood dynamics in the pulmonary edema rabbits after seawater drowning(PE-SWD). Methods:Totally 42 healthy male New Zealand rabbits were randomly allocated into 3 groups (n=14);each group was treated with various methods after PE-SWD model was established:PE group with no treatment,CMV group with conventional mechanical ventilation and positive end-expiratory pressure(PEEP),PLV group with CMV,PEEP and FDC.After being treated for 3 h,blood gases,pulmonary mechanics,hemodynamics,pulmonary histopathology and survival time were observed.Results:In PLV group,PaO 2 increased obviously and reached (262.84?64.33) mmHg (1 mmHg=0.133 kPa), airway pressure decreased by 23.4%,pulmonary static compliance increased by 31.3% and TNF-? decreased by 24.9%.HR and MAP showed no significant changes after treatment compared with PE group.Conclusion: Pulmonary gas exchange and compliance are improved significantly during PLV in the PE-SWD rabbits without obvious influence on hemodynamic status, although the survival time of PLV group is less than that of CMV group.
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Objective: To observe the therapeutical effect of intermittent positive pressure ventilation (IPPV) on pulmonary edema after seawater drowning in rabbits.Methods:Fourteen seawater lavage induced pulmonary edema New Zealand rabbits models were assigned to receive IPPV treatment.Blood gas analysis, pulmodynamics, hemodynamics status and serum tumor necrosis factor(TNF ?) were monitored at various time points.After 3 h ventilation rabbits of each group were killed to gain lung tissues for pathology examination, and lung lavage fluid was analyzed to count leukocytes.Results:PaO 2 significantly increased after the use of ventilation in pulmonary edema rabbits models ( P