An investigation on early identification and comprehensive intervention for reducing risk of acute poisoning with inhalation pneumonia / 中国中西医结合急救杂志

ABSTRACT

Objective To observe the effect of early comprehensive intervention on the clinical efficacy of patients with acute poisoning combined with inhalation pneumonia. Methods One hundred and eighty-seven patients with acute severe poisoning combined with coma [Glasgow coma scale (GCS) ≤ 8] were admitted to the department of emergency intensive care unit (EICU) of Luoyang Central Hospital Affiliated to Zhengzhou University from January 2013 to December 2016. Forty-eight patients treated from January 2013 to December 2014 by conventional and symptomatic therapies were taken as a control group, and 56 cases treated with early comprehensive intervention method from January 2015 to December 2016 were assigned as an experimental group. The differences in the incidences of aspiration pneumonia and respiratory failure, the usage rate of antimicrobial drugs and their combination condition, length of hospital stay, length of stay in ICU and prognosis were compared between the two groups. Results After treatment, the incidence of aspiration pneumonia [10.71% (6/56) vs. 58.33% (28/48)], and the incidence of respiratory failure [8.93% (5/56) vs. 29.17% (14/48)] in the experimental group were significantly lower than those in the control group, the utilization rate of antimicrobial drugs [14.3% (8/56) vs. 62.5% (30/48) ], especially the combined use of triple and above was significantly reduced [0 vs. 10.0% (3/30)], the length of hospital stay (days 7.80±3.79 vs. 10.21±4.58) and length of stay in ICU (days 3.48±1.56 vs. 6.56±2.92) were obviously shorter in experimental group than those in control group (both P < 0.05). The clinical cure rate was also significantly higher in the experimental group [91.07% (51/56) vs. 77.08% (37/48), P < 0.05]. Conclusions The early comprehensive intervention for treatment of patients with GCS score ≤ 8 and acute poisoning can reduce the risks of the occurrences of inhalation pneumonia and respiratory failure and improve the medical pharmacy index and the prognosis of patients, thus the method is worthwhile to be applied extensively.