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OBJECTIVE: To explore the clinical application effect of noninvasive mechanical ventilation for patients with acquired immune deficiency syndrome (AIDS) complicated with pneumonia. METHODS: A prospective study was conducted on 86 patients with AIDS complicated with pneumocystis pneumonia. The patients were randomly divided into a control group and an experimental group, both of which were treated with conventional drugs. The control group was supplemented with oxygen via a mask, and the experimental group was additionally treated with noninvasive ventilator ventilation. The changes of arterial oxygen partial pressure, oxygenation index, respiratory frequency, pulse rate, serum albumin and other indicators between the two groups before and after treatment were observed. The patient's hospitalization time, overall improvement and mortality rate were compared. RESULTS: Compared with those before treatment, the arterial oxygen partial pressure, oxygenation index, respiratory frequency, and pulse rate of the two groups of patients were significantly improved after treatment (P<0.05). The improvement of the experimental group after treatment was more significant than that of the control group, and the difference was statistically significant (P<0.001). After treatment, the proportion of recovery rate of serum albumin in the experimental group was 81.40%, which was significantly higher than that in the control group (53.49%), and the difference was statistically significant (P<0.05). Compared with the control group, hospitalization time, treatment improvement and mortality rate in the experimental group had significant advantages and statistical significance (P<0.05). CONCLUSION: For AIDS patients complicated with pneumonia, noninvasive mechanical ventilation had obvious treatment effects, which could significantly improve respiratory function, reduce mortality rate, and increase recovery rate. It can be considered as a therapeutic method to be included in routine treatment protocols.
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Objective To compare the efficacy of surgical treatment(ST) and mechanical ventilation treatment(MVT) for flail chest.Methods From March 2013 to May 2017,81 patients with flail chest who underwent ST(28 cases) and MVT(53 cases) were enrolled in ICU.The relevant indicators of efficacy were compared including mechanical ventilation (MV) time,bed rest time,oxygen administration time,catheterization time,antibiotic use time,drug analgesia,drug analgesia patients,proportion of stop/postoperative sputum alone,ICU treatment time,hospital stay,mortality,readmission within two months and long-term pulmonary function after discharge.Results The MV time,bed time,oxygen time,antibiotic use time,ICU treatment time and hospitalization time of MVT were longer than those of ST group,the differences were significant(P ＜ 0.05).MVT had more analgesic times,more analgesic cases,smaller proportion of offline/postoperative sputum along and less hospitalization fees compared with ST group,the differences were significant(P ＜0.05).There was no significant difference in the main indexes of pulmonary function between two groups in 3 months after discharge.Conclusion ST and MVT respectively has advantages and disadvantages for flail chest.There is no significant difference in long-term pulmonary function of ST and MVT.While MVT has less trauma and lower cost.The appropriate treatment could be selected according to the clinical situation.
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Objective To propose the concept of “Diffusion Index”to replace Oxygenation Index as independent indicators to evaluate prognosis on ARDS patients under mechanical ventilation treatments,and comparison carried out between them preliminarily.Methods Calculation of “1 000 × (PaO2 /FiO2 /PEEP)”was taken as “Diffusion Index”.A total of 130 ARDS patients under mechanical ventilation support (MVS)were admitted to Peking Union Medical College Hospital ICU from July 2013 to July 2014.The data of these patients were retrospectively analyzed.Of them,15 patients were excluded because these patients refused invasive ventilation support.Respirator parameter setting and haemogas figures were recorded accordingly. Both Diffusion Index and Oxygenation Index were used separately to predict detachment of MVS from patients in 28 days,and the correlation between these two indexes and ARDS prognosis were determined.Results According to the outcomes of patients in 28 days,patients were divided into 3 groups:detached group (n =44),failed to detach group (n =14)and death group (n =57).There was obvious difference in trend diagrams observed among three groups between diffusion index and oxygenation index.COX regression analysis of survival curve demonstrated that if Diffusion Index kept greater than 405.8,probability of detachment of MVS from patients was higher and the correlation was significant (P =0.009 ).Conclusions Compared with Oxygenation Index,“Diffusion Index” is a comprehensive indicator for ARDS prognosis with better reliability and validity.
