Effect of nursing intervention based on 6-hour resuscitation goal theory on quality of life and various functions of sepsis patients / 中国中西医结合急救杂志

ABSTRACT

Objective To explore the effect of nursing mode based on 6-hour resuscitation goal theory on various functions and quality of life of patients with sepsis. Methods One hundred and forty-two septic patients admitted to the Second Affiliated Hospital of Wenzhou Medical University from April 2016 to July 2018 were enrolled. A total of 71 patients selected to use traditional nursing intervention strategy were assigned in the routine nursing group;in the 6-hour resuscitation target theory group, 71 patients were given nursing care based on 6-hour resuscitation target theory on the basis of traditional routine nursing. The differences in oxygenation function indexes [central venous blood oxygen saturation (ScvO2), arterial partial pressure of oxygen (PaO2) and oxygenation index (PaO2/FiO2)], circulatory function indexes [central venous pressure (CVP), mean arterial pressure (MAP) and heart rate (HR)], renal function indexes [urine volume and serum creatinine (SCr)] before and after intervention for 6 hours were compared between the two groups of patients; at the same time, the survival rate, treatment status and life quality improvement of the two groups after 1 month of intervention were recorded. Results After 6 hours of intervention, CVP, MAP, ScvO2, PaO2, PaO2/FiO2, urine volume and quality of life scores of patients in the 6-hour resuscitation target theory group and the routine nursing group were all increased compared with those before intervention, while the HR and SCr levels were lower than those before the intervention, moreover, the changes above indexes in the 6-hour resuscitation target theory group were more significant than those in the routine nursing group [CVP (cmH2O, 1 cmH2O = 0.098 kPa) 11.89±2.94 vs. 7.33±2.37, MAP (mmHg, 1 mmHg = 0.133 kPa) 84.11±6.13 vs. 66.15±5.27, HR (bpm)89.05±6.00 vs. 102.41±5.86, ScvO2 0.78±0.03 vs. 0.66±0.04, PaO2 (mmHg) 154.71±20.75 vs. 106.54±24.66, PaO2/FiO2 (mmHg) 364.13±38.47 vs. 331.21±33.26, urine volume (mL/h) 71.13±10.22 vs. 37.42±13.41, SCr (μmol/L) 113.10±14.35 vs. 125.12±13.87, role function scores 87.82±4.52 vs. 71.28±4.92, cognitive function scores 89.23±4.63 vs. 71.75±5.34, body function scores 90.24±4.43 vs. 72.74±5.03, emotional function scores88.92±5.71 vs. 73.42±3.48, social function scores 94.31±2.71 vs. 75.21±4.83, all P < 0.05]. One month after intervention, the survival rate in the 6-hour resuscitation target theory group was higher than that in the routine nursing group [69.01% (49/71) vs. 42.25% (30/71), P < 0.05], compared with routine nursing group, stay time in intensive care unit (ICU) and mechanical ventilation time in the 6-hour resuscitation target theory group were significantly shortened [stay time in ICU (days) 7.34±3.31 vs. 9.42±3.60, mechanical ventilation time (days) 3.52±0.84 vs. 5.83±0.85, both P < 0.05]. Conclusion The application of nursing intervention based on 6-hour resuscitation target theory for patients with sepsis has very significant effects on promoting the patients' oxygenation, renal and circulatory functions, and improving their survival rate and quality of life.