RESUMO
Hyperoxia is very common in critical patients, which causes varying degrees of pathophysiological damage. Hyperoxia is one of the main reasons for increasing mortality, prolonged hospital stay and poor prognosis of critical patients. Therefore, it is critical to carry out the standardized oxygen therapy. In this paper, we discussed the harmful effects of hyperoxemia to critically ill patients by reviewing the effect of hyperoxemia on cardiovascular and cerebrovascular, hyperoxia-induced lung injury, and the association of hyperoxemia with ventilator-associated pneumonia (VAP) and acute renal kidney injury (AKI). Meanwhile, we provided some management suggestions about standardized clinical oxygen therapy, oxygen therapy related research and clinical management of oxygen therapy, aimed at providing reference and research direction for standardizing clinical oxygenation process, reducing the occurrence of hyperoxemia, and making reasonable method for hyperoxemia prevention.
RESUMO
Objective To develop a kind of new machine for making animal model for pressure ulcer,and inspect its effect through experiments,in order to lay the foundation for the research of pressure ulcer experiments on animals.Methods This study developed the machine after reviewing the domestic and foreign literature,making full use of the existing experimental platform of our university.Then 55 Sprague Dawley(SD) rats were selected,after anesthesia and the skin preparation,the researchers imposed certain pressure with 70 mmHg/cm2 (1 mmHg=0.133 kPa) on the skin and muscle tissue on the inner left thigh of SD rats by using self-designed machine,pressing for 2 h,then reperfusion for 30 min,3 times a day,a total of 7 days.Results The authors developed a kind of new machine for making animal model for pressure ulcer,and successfully prepared Ⅲ phase pressure ulcers model in SD rats with success rate of 98.2％(54/55).Conclusion This machine can prepare Ⅲ phase pressure ulcers model on animals,it's easy to use and efficient,it can be used for researches in the field of prevention and cure of pressure ulcers.
RESUMO
Objective To assess the effectiveness and safety of heat moisture exchangers (HMEs) on the artificial airway humid-ification in the mechanically ventilated patients .Methods The related literature in the Cochrane Library ,PubMed ,Embase ,CNKI , VIP ,WanFang database and CBM from the establishment to March 2012 were retrieved ,then included the randomized controlled trial(RCT) and quasi-RCT on the effect of HMEs for the artificial airway humidification in the mechanically ventilated patients were performed the meta analysis by using RevMan 5 .1 .2 software .Results 19 RCT were included(involving 2 960 patients) , which were the random parallel controlled trials .The meta analysis results showed that HMEs could not reduce the incidence rate of ventilator-associated pneumonia(VAP)(RR=0 .78 ,95% CI 0 .61-1 .01 ,P=0 .06) ,also could not decrease the hospitalization mor-tality(RR=0 .94 ,95% CI 0 .83-1 .08 ,P=0 .40) ,the length of ICU stay(MD= -0 .32 ,95% CI -3 .13 -2 .50 ,P=0 .82) and the occurrence rate of catheter occlusion (RR=0 .65 ,95% CI 0 .22 -1 .93 ,P= 0 .44) ,the differences between the two groups had no statistical significance .But 5 RCT reported that using HMEs could reduce the patient′s costs .Conclusion HMEs can not reduce the incidence rate of VAP ,mortality ,length of ICU stay ,occurrence rate of airway occlusion ,but can cut down the patient′s cost . Due to the risk of bias existing in all included RCT and the low quality of the obtained evidences ,more strictly designed and imple-mented RCTs are needed to further verify thse evidences .
RESUMO
Objective To systematically analyze and evaluate the intervention effect of foreign and domestic research about needlestick injuries in medical staffs and provide the basis for reducing the rate of occupational exposure of medical staffs.Methods The intervention study of needlestick injuries in medical staffs between 1981 and 2013 were collected in CNKI,VIP,Wanfang and PubMed databases,Metaanalysis was conducted for the included studies by RevMan5.2 software.According to I2 and P value heterogeneity was determined,choose a fixed or random effect model to analyze and merge the data to measure the effect of the intervention by OR and 95％ confidence intervals (C I).Results The total of included studies was 19,the number of the intervention group and the control group was 20 592 and 19 855,the OR and 95％ CI of intervention effect as shown below:comprehensive intervention OR=0.40,CI 95％ (0.27～0.59),education and training OR=0.24,CI 95％ (0.11～0.55),safety management OR=0.09,CI 95％ (0.06～0.13),engineering intervention OR=0.30,CI 95％ (0.16～0.55),safe operation OR=0.15,CI 95％ (0.09～0.26).The intervention group and the control group were statistically significant on reducing the incidence of needlestick injuries.Conclusions Education and training,safety management,engineering intervention,and safe operation can reduce the incidence of needlestick injuries,improve the quality of life of medical staffs.
RESUMO
Objective To evaluate the efficacy of traditional Chinese medicine which eliminating necrotic tissues and promoting granulation on pressure ulcer of Ⅲ to Ⅳstage using Meta analysis.Methods RCTstudies of therapy of eliminating necrotic tissues and promoting granulation traditional Chinese medicine for stage Ⅲ～Ⅳ pressure ulcer were searched,in which the control groups used routine methods,while the experimental groups adopted necrotic tissues and promoting granulation traditional Chinese medicine.Two reviewers assessed the documents'quality separately and completed data extraction.The statistical analysis was performed using the Cochrance collaborations' Rev Man 5.1 software.Results The cure rates for pressure ulcers of the experimental groups were higher than the control groups.The time of recovery of the experimental groups were shorter than the controls.The dressing change frequency of the experimental groups was less than the controls.Conclusions Traditional Chinese medicines which eliminating necrotic tissues and promoting granulation can significantly improve the cure rate,shorten the therapeutic time and reduce the frequency of dressing change.