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Objective To evaluate the effect of high flow nasal catheter oxygen (HFNCO) therapy on extubation failure rate,reintubation rate,and incidence of related complications within 48 h after extubation in mechanically ventilation patients.Methods A prospective,single-center,randomized controlled trial was conducted in the ICU of a teaching hospital affiliated to a medical university.A total of 77 patients with mechanical ventilation duration of ≥ 48 h and met the condition of spontaneous breathing test (SBT) were selected.The patients whose LUS ≥ 14 at 30 min of SBT were enrolled,and were randomly (random number) divided into 3 groups according to different oxygen therapies:the traditional oxygen therapy group,the noninvasive ventilation (NIV) group,and the HFNCO group.The effect of oxygen therapy and outcomes after extubation were compared among the three groups.The measurement data were presented as the mean±standard deviation (SD),and the numeration data were expressed as ratio or constituent ratio.The independent sample t test and LSD-t test were used for the comparisons between the two groups and the one-way ANOVA for differences between multiple groups.The differences between enumeration data were assessed by chi-square test.A P＜0.05 was considered statistically significant.Results There was no significant difference in gender,age and other general conditions between the two groups (P＞0.05).The NIV group and HFNCO group had lower extubation failure rate (14.29％,15.38％ vs 34.87％) and reintubation rate (10.7％,11.54％ vs 21.74％) than the convertional oxygen therapy group (P＜0.05).In addition,the traditional oxygen therapy group had longer mechanical ventilation duration [(24.33±4.42) d vs (8.58±1.09) d,(8.37±2.43) d],antibiotic use time [(19.21±4.37) d vs (8.34±2.54) d,(7.41±1.06) d],and ICU hospitalization time [(27.27±4.24) d vs (10.38±2.07) d,(9.44±0.79) d],all P＜0.05.Conclusions Treatment with HFNCO or NIV after extubation can effectively reduce the rates of extubation failure and reintubation,and improve the outcome of the mechanical ventilation.There is no difference in clinical efficiency between the NIV group and HFNCO group.However,compared with NIV,HFNCO can effectively reduce respiratory rate and avoid the retention of CO2,which has a wider application prospect in clinical practice.
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Objective@#To evaluate the effect of high flow nasal catheter oxygen (HFNCO) therapy on extubation failure rate, reintubation rate, and incidence of related complications within 48 h after extubation in mechanically ventilation patients.@*Methods@#A prospective, single-center, randomized controlled trial was conducted in the ICU of a teaching hospital affiliated to a medical university. A total of 77 patients with mechanical ventilation duration of≥ 48 h and met the condition of spontaneous breathing test (SBT) were selected. The patients whose LUS≥14 at 30 min of SBT were enrolled, and were randomly (random number) divided into 3 groups according to different oxygen therapies: the traditional oxygen therapy group, the noninvasive ventilation (NIV) group, and the HFNCO group. The effect of oxygen therapy and outcomes after extubation were compared among the three groups. The measurement data were presented as the mean±standard deviation (SD), and the numeration data were expressed as ratio or constituent ratio. The independent sample t test and LSD-t test were used for the comparisons between the two groups and the one-way ANOVA for differences between multiple groups. The differences between enumeration data were assessed by chi-square test. A P<0.05 was considered statistically significant.@*Results@#There was no significant difference in gender, age and other general conditions between the two groups (P>0.05). The NIV group and HFNCO group had lower extubation failure rate (14.29%, 15.38% vs 34.87%) and reintubation rate (10.7%, 11.54% vs 21.74%) than the conventional oxygen therapy group (P<0.05). In addition, the traditional oxygen therapy group had longer mechanical ventilation duration [(24.33±4.42) d vs (8.58±1.09) d, (8.37±2.43) d], antibiotic use time [(19.21±4.37) d vs (8.34±2.54) d, (7.41±1.06) d], and ICU hospitalization time [(27.27±4.24) d vs (10.38±2.07) d, (9.44±0.79) d], all P<0.05.@*Conclusions@#Treatment with HFNCO or NIV after extubation can effectively reduce the rates of extubation failure and reintubation, and improve the outcome of the mechanical ventilation. There is no difference in clinical efficiency between the NIV group and HFNCO group. However, compared with NIV, HFNCO can effectively reduce respiratory rate and avoid the retention of CO2, which has a wider application prospect in clinical practice.
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Objective To study the effect of evidence-based nursing in patients with cerebral apoplexy in ICU by blind bedside spiral nasointestinal tube application.Methods To choose between September 2016 and September 2017 in our hospital ICU were 140 cases of patients with cerebral apoplexy as analysis object,randomly divided into two groups,two groups all use bedside blind spiral nose long intestinal tube technology,the control group using conventional nursing method for nursing,observation group using evidence-based nursing intervention,compared two groups of a success rate of catheter,accident to take off the tube (unscheduled decannulation rate),reflux hiccups,vomiting incidence of aspiration and patient satisfaction.Results The success rate of catheterization in the observation group was higher than that in the control group,and the incidence of accidental catheterization was lower than that in the control group.The incidence of reflux hiccup and vomiting aspiration was significantly lower than that in the control group,and the patient satisfaction was higher than that in the control group (all P＜0.05).Conclusion For patients with cerebral apoplexy in the ICU bed of blind plug spiral nasal bowel technology combined evidence-based nursing intervention,clinical effect is remarkable,improve the success rate of catheter,reduces the surprise success rate of tube,unscheduled tube drawing number,reduces the incidence of reflux hiccups,vomiting aspiration,improve patient satisfaction and quality of life.
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Objective To investigate the effect of X-ray assisted nasal catheter extractor on nose biliary oronasal conversion. Methods A total of 892 patients,receiving endoscopic nasal biliary drainage in Affiliated Zhongshan Hospital of Dalian University from January 2014 to December 2015, were randomly divided into experiment group and control group. X-ray assisted nasal catheter extractor was used in the experiment group,and guide wire was used in the control group. The mean extracting number and operation time, the total success rate, one-time success rate, response to stimulation and the incidence of complications were compared between the two groups. Results There were 457 cases in the experiment group. The mean extracting number was 1.08±0.32,the mean operation time was 1.07±0.29 min,the total success rate was 100.00%(457/457)and one-time success rate was 93.65%(428/457). The stimulation degree score was 1.27±0.50 with 348 cases of mild response,96 cases of moderate response and 13 cases of severe response. The rate of adverse reaction was 15.54%(71/457)with 50 cases of nausea, 18 cases of vomiting and 3 cases of mucosal bleeding. There were 435 cases in control group. The mean extracting number was 1.68±0.61,the mean operation time was 1.75±0.53 min, the total success rate was 75.63%(329/435)and one-time success rate was 38.16%(166/435). The stimulation degree score was 1.59 ±0.62 with 210 cases of mild response,194 cases of moderate response and 31 cases of severe response. The rate of adverse reaction was 35.86%(156/435)with 87 cases of nausea,36 cases of vomiting,27 cases of mucosal bleeding,and 6 cases of nasal duct prolapsed for vomiting. There were significant differences in the mean extracting number, mean operation time, stimulation degree score and the adverse reaction rate between the two groups(all P<0.001). The total success rate and one-time success rate in the experiment group were higher than those in the control group(all P<0.001).Conclusion X-ray assisted nasal catheter extractor can improve the success rate of operation,shorten the operation time,reduce the stimulation degree and the rate of adverse reactions in nose biliary oronasal conversion.
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Objective To evaluate the effect of type WIYIS-6/90 plateau oxygen generating vehicle on the high altitude spot. Methods Totally 20 male soldiers during field training at 4 280 m altitude were involved in this trial. They were given administration of oxygen inhalation at 2 L/min by nasal cannula. Blood pressure, heart rate, blood oxygen saturation, vital capacity, left and right hand strength, digit span and discriminative reaction time were detected before and after oxygen inhalation for 20 minutes and finished for 10 minutes. Results After oxygen inhalation for 20 minutes, blood oxygen saturation, vital capacity, left and right hand strength, digit span and correct times increased and heart rate decreased compared with before oxygen inhalation (P<0.05,or P<0.01).Stopping oxygen inhalation for 10 minutes,vital capacity and right hand strength increased and response time decreased(P<0.05,or P<0.01).Conclusion Using type WIYIS-6/90 plateau oxygen generating vehicle for oxygen supply at high altitude can improve brain-body function and promote work ability.
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Objective To evaluate the effects of the application of high-flow nasal cannula (HFNC)for the respiratory failure following radical resection of pulmonary carcinoma. Methods A total of 48 patients with radicalsurgeryofpulmonarycarcinoma effect postoperative failure from February 2015 to August 2016 were randomly divided into observation group(24 cases) and control group(24 cases) with digital table method.The observation group was received with HFNC,and the control group with oxygen atomization mask 8-10 L/min.The heart rate,respiratory rate,PaO2,PaCO2and oxygenation index(PaO2/FiO2)changes were evaluated before treatment,treatment for 1,6,24 h and at the end of the treatment in both groups, at the same time, noninvasive positive pressure ventilation (NPPV) rate, again intubation mechanical ventilation rate, incidence of ventilator associated pneumonia (VAP), ICU confusion assessment (CAM-ICU) positive rates and ICU stay time were compared in the course of treatment of difference. Results Through two different methods of treatment, the heart rate, respiratory rate, PaO2, PaCO2,PaO2/FiO2were(78.88±12.03)times/min,(18.96±7.53)times/min,(140.2±18.37)mmHg(1 mmHg=0.133 kPa),(37.04±7.67)mmHg,(242.83±27.13)mmHg in the observation group,respectively,compared with(88.83±16.48)times/min,(25.46±9.51)times/min,(86.08±20.83)mmHg,(45.71±10.37)mmHg and(210.71±36.34)mmHg in the control group,which had significant differences(t=-3.922-3.415,P<0.05). The ICU stay time in the observation group was( 68.71 ± 32.38) h, respectively, which was much shorter than that in the contorl group(107.67±66.15) h, the difference was statistically significant (t=2.416, P<0.05). The occurrence rates of NPPV and the positive rates of CAM-ICU were16.7%(4/24),4.2%(1/24)in the observation group,respectively,compared with 45.8%(11/24),33.3%(8/24)in the control group,which had significant differences(x2=4.752,4.923,P<0.05). Conclusions HFNC is a new and effective way of oxygen therapy that can better improve circulation oxygenation,reduce PaCO2,reduce the rate of line of NPPV and CAM-positive rate in the ICU,and can shorten the patient's ICU stay time in the treatment of lung cancer patients with postoperative respiratory failure.
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Objective To observe the reintubation rate of acute respiratory failure after thymectomy in patients with myasthenia gravis (MG) by two kinds of oxygen therapy (HFNC) and noninvasive mechanical ventilation. Methods Sixty-seven patients were treated with HFNC (observation group), and 80 patients were treated with noninvasive mechanical ventilation(control group). The baseline of the two groups was comparable. Results The rate of re-intubation and ICU stay time was 18.42%(14/76) , (5.35 ± 1.95) din control group and 7.50%(6/80), (3.42 ± 1.61) d in observation group. The difference was statistically significant (χ2=4.159,P =0.041;t =5.135,P=0.025).The respiratory rate、SpO2, PaO2, PaCO2 was (28.27 ± 4.32)beats/min, 0.9107 ± 0.0130, (86.43 ± 5.66)mmHg, (57.44 ± 5.73) mmHg in observation group and (24.84 ± 2.48) beats/min, 0.8867 ± 0.0309, (81.31 ± 2.85) mmHg, (65.38 ± 10.00) mmHg in control group. The difference was statistically significant (t =5.189-58.502,all P<0.01 or<0.05). Conclusion HFNC can improve the respiratory function of patients with myasthenia gravis after thymectomy, reduce the incidence of respiratory failure and re-intubation rate.
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Objective To observe the reintubation rate of acute respiratory failure after thymectomy in patients with myasthenia gravis (MG) by two kinds of oxygen therapy (HFNC) and noninvasive mechanical ventilation. Methods Sixty-seven patients were treated with HFNC (observation group), and 80 patients were treated with noninvasive mechanical ventilation(control group). The baseline of the two groups was comparable. Results The rate of re-intubation and ICU stay time was 18.42%(14/76) , (5.35 ± 1.95) din control group and 7.50%(6/80), (3.42 ± 1.61) d in observation group. The difference was statistically significant (χ2=4.159,P =0.041;t =5.135,P=0.025).The respiratory rate、SpO2, PaO2, PaCO2 was (28.27 ± 4.32)beats/min, 0.9107 ± 0.0130, (86.43 ± 5.66)mmHg, (57.44 ± 5.73) mmHg in observation group and (24.84 ± 2.48) beats/min, 0.8867 ± 0.0309, (81.31 ± 2.85) mmHg, (65.38 ± 10.00) mmHg in control group. The difference was statistically significant (t =5.189-58.502,all P<0.01 or<0.05). Conclusion HFNC can improve the respiratory function of patients with myasthenia gravis after thymectomy, reduce the incidence of respiratory failure and re-intubation rate.
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Doze cães, sem raça definida, foram submetidos à toracotomia lateral intercostal e divididos em dois grupos de diferentes tratamentos pós-operatórios, sendo que seis animais receberam oxigenoterapia por cateterização nasal e os demais não receberam este tratamento. Os animais de ambos os grupos estiveram sob cuidados intensivos em sala de recuperação por quatro horas de período pós-operatório, quando foram monitorados o volume corrente pulmonar, a gasometria arterial, o tempo de reperfusão capilar, a coloração de mucosas ocular e oral, as frequências respiratória e cardíaca, a temperatura retal e a tolerância ao uso do cateter nasal. Os resultados obtidos demonstraram que ocorre diminuição dos valores de pressão parcial arterial de oxigênio abaixo dos índices fisiológicos. A análise estatística dos dados revelou diferença significativa entre os cães que receberam oxigênio via cateter nasal e os não tratados, no período pós-toracotomia.
Lateral intercostal thoracotomy was performed in twelve mongrel dogs divided in two groups for different postoperative treatments. Six animais received oxigen by nasal catheter after surgery. Both groups were maintained in a recovery room during four hours in wich were monitored the pulmonary tidal volume, the arterial blood gas values, the capilar refil l time, the mucous membrane color, the respiratory and heart rates, the rectal temperature, and the tolerance to the nasal catheter. The results demonstrated a reduction on the arterial oxygen parcial pressure levels after the thoracotomy. The comparativo statistical analyse showed a significant diference between the group that received oxygen by nasal catheter and the group that recived no treatment.