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Objective To investigate the clinical effect of the improved continuous subglottic approach in patients with mechanical ventilation. Methods A total of 90 ICU patients with mechanical ventilation , were divided into observation group and control group 1 and control group 2 by random digits table method,each group was 30 cases.The observation group used the improved continuous subglottic suction. The control group 1 used the way of continuous 24 h suction under glottis. The control group 2 used the way of every 2 h suction under glottis combined with subglottic. The incidence of ventilator-associated pneumonia (VAP), the rate of tube blockage, the amount of subglottic secretion and the damage of airway mucosa were observed. Results The incidence of 7 d VAP in the observation group was 3.33％(1/30), which was not significantly different from that in the control group 1 and the control group 2 (P>0.05), but it was lower than the incidence of VAP at home and abroad. The rate of plugging in the observation group was 6.67％(2/30), and that in the control group 1 was 23.33％(7/30), and the difference was statistically significant (χ2=4.320, P<0.05). The daily flow rate of subglottic secretion was (30.93 ± 8.01) ml/d in the observation group, and (19.75 ± 6.52) ml/d in the control group 2, the difference was statistically significant (t=7.542, P<0.05). The injury rate of airway mucosa in the observation group was 10.00％(3/30), and 33.33％(10/30) in the control group 1, the difference was statistically significant (χ2=4.812, P<0.05). Conclusions The improvement suction under glottis method can be widely applied in clinical practice,which can effectively reduce the incidence of VAP, subglottic tube plugging rate, fully drainage of subglottic secretions, the degree of airway mucosa damage, reduce nursing workload compared with intermittent subglottic.
RESUMO
Objective To discuss the influence about three kinds of nasal feeding methods on ICU critical patients with gastrointestinal complications, thus providing guidance for ICU patients to choose reasonable way of nasal feeding pump injection. Methods 120 ICU patients were randomly assigned into three groups, which is the continuous 6-hour and intermittent 2-hour every three time pump group and continuous 24-hours pump group and intermittent 24-hour(continuous 2-hour and intermittent 1-hour every eight time units)pump group ,each group has 40 cases. To observe the the influence about three different way of nasogastric on ICU critical patients with gastrointestinal complications. Results The incidence of diarrhea and constipation among the three groups was not statistically significant (P>0.05) . The gastric retention rate of the continuous 24-hour pump group was significantly higher than that of the continuous 6-hour and intermittent 2-hour pump group and the intermittent 24-hour pump group, the differences were statistically significant (P 0.05). Conclusions The continuous 24-hour pump group in gastric retention was slightly worse than the other two pump way. Compared with ICU class three a week and feeding times , the continuous 6-hour and intermittent 2-hour pump method is more suitable for ICU patients.
RESUMO
Objective To objectively evaluate the effectiveness of reminder system in reducing catheter-associated urinary tract infections.Methods Databases were electronically searched to collect the trials.According to the inclusion and exclusion criteria,the literatures were screened,the data were extracted and the methodological quality of the included studies was assessed.Then Meta-analysis was performed by using RevMan 5.0 software.Results A total of 10 literatures involving 5 662 participants were included.The results of Meta-analysis showed that the reminder system group was superior to the control group in decreasing the incidence rate of catheter-associated urinary tract infections,shortening the days of indwelling catheter,and there were statistical differences.Conclusions Reminder system can shorten the days of indwelling catheter,decrease catheter-associated urinary tract infections,