Application of Venturi combined with MR850 in ventilator offline patients with tracheotomy / 中华危重病急救医学

ABSTRACT

Objective To investigate the effect of oxygen therapy with Venturi combined with MR850 heating humidifier on patients without mechanical ventilation after tracheotomy. Methods Eighty patients (≥ 18 years old) who had undergone tracheotomy and without mechanical ventilation admitted to Fenyang Hospital of Shanxi Province from June 2016 to December 2017 were enrolled, and they were divided into control group and observation group according to random number table method, with 40 patients in each group. The observation group was given Venturi (removed the mask) combined with MR850 device active warm and humid oxygen therapy; the control group was given one-off ordinary flow device and warm and humid exchanger (artificial nose, HME) passive humid oxygen therapy. Body temperature increased by 1 ℃ above basal body temperature, white blood cell count (WBC) increased 2×109/L than the base value, oxygenation index (PaO2/FiO2) < 300 mmHg (1 mmHg = 0.133 kPa), airway mucosal hemorrhage, pulmonary infection and sputum viscosity were observed in the two groups for 5 days after oxygen therapy. Results Among the 80 patients, there were 46 males and 34 females, with an average age of (67.7±12.2) years. Compared with the control group, the incidence of increased body temperature (5.0% vs. 20.0%), the incidence of increased WBC (7.5% vs. 35.0%), the incidence of low PaO2/FiO2(2.5% vs. 7.5%), the incidence of airway mucosal bleeding (5.0 % vs. 15.0%) and the incidence of pulmonary infection (2.5% vs. 10.0%) were significantly decreased in the observation group (all P < 0.01), and the proportion of sputum viscosity Ⅰ degree of patients was significantly increased (57.5% vs. 12.5%, P < 0.01). Conclusion Venturi combined with MR850 device can effectively control airway temperature and humidity, promote sputum dilution and conducive to drainage, reduce pulmonary infection in adults patients without mechanical ventilation after tracheotomy, thereby reducing postoperative complications of tracheotomy.