Analysis of duration of ICU delirium and its influencing factors / 中华护理杂志

Objective To describe the status of duration of ICU delirium and to analyze its influencing factors.Methods We studied patients who were delirium positive from April 2016 to January 2017 in ICU in Peking Union Medical College Hospital.We collected general information and clinical information including mechanical ventilation,usage of sedation,analgesia and antipsychotics,hypoxia,infection,internal environment and types of delirium after initial onset of delirium.We also recorded management of delirium patients until resolution of delirium or patients were discharged from ICU.We analyzed data by Kaplan-Meier single factor analysis and Cox multiple-factors analysis.Results The average duration of ICU delirium was(5.06±4.59) days.APACHE Ⅱ score(x2=4.670,P=0.031),persistent delirium or not(x2=5.801,P=0.016),duration of hypoxia(x2=14.438,P＜0.001),and duration of usage of antipsychotics(x2=13.360,P＜0.001)were influencing factors of delirium duration.Conclusion Duration of ICU delirium has huge variation.To decrease duration of ICU delirium and improve outcomes of patients,medical workers should pay attention to patients with high APACHE score,persistent delirium and hypoxia,and be cautious when using antipsychotics.

Application of ultrasonography guided water injection for insertion of naso-jejunal tubes / 中华护理杂志

Objective To examine the effects of application of ultrasonography guided water injection for inser-tion of naso-jejunal tubes. Methods Hospitalized patients in ICU who needed naso-jejunal tubes were recruited from one tertiary hospital in Beijing from November 2016 to April 2017. Ultrasonography guided water injection was used to assist insertion of naso-jejunal tubes. Meanwhile,we conducted semi-structured interviews to learn feel-ings and suggestions from the patients. Results A total of 40 patients were included in this study,37 patients (92.5%) were successfully inserted with the tubes at the first attempt. The duration of insertion of naso-jejunal tubes was 25 (20,38.75) min. Conclusion Ultrasonography guided water injection is a simple and convenient method to guide the placement of naso-jejunal tubes for critical ill patients,which provides guarantee for early en-teral nutrition.