Objective: The objective is to investigate the incidence and consequences of arterial line occlusion during invasive blood pressure monitoring in the form of questionnaire survey. Methods: The questionnaires were rand...Objective: The objective is to investigate the incidence and consequences of arterial line occlusion during invasive blood pressure monitoring in the form of questionnaire survey. Methods: The questionnaires were randomly distributed to the anesthesiologists who participated the 22<sup>nd</sup> annual meeting of Chinese society of anesthesiology. The main contents of this survey included the arterial line managing status, the incidence of arterial line occlusion, the effects of arterial line occlusion on the anesthesiologists’ therapy and consequences caused by arterial line occlusion. Results: Totally 294 questionnaires were collected, in which 261 questionnaires were valid. In all respondents, 28.3% expressed that they could not flush arterial line on time, and 95.4% had experienced flushing arterial line only or sometimes or occasionally when the arterial waveform was not normal. Furthermore, 93.9% had experienced partial occlusion of the arterial line, and 79.3% had experienced complete occlusion. According to the serious recall of the respondents, the incidence of partial arterial line occlusion was 17.7% ± 22.0%, and the incidence of complete arterial line occlusion was 3.6% ± 8.1%. For all the respondents, 89.7% had experienced suspecting arterial line occlusion while real hypotension occurred, 65.1% had experienced not treating hypotension timely due to this suspicion, and 31% had experienced serious consequences caused by this suspicion. Conclusion: The incidence of arterial line occlusion is high during invasive blood pressure monitoring, which is a threat to the patients’ safety. So, intensive attention should be paid to the arterial line management.展开更多
Objective: To study the clinical value of positive pressure infusion joint combined with cluster nursing intervention in invasive blood pressure monitoring of critically ill patients. Methods: A total of 56 patients w...Objective: To study the clinical value of positive pressure infusion joint combined with cluster nursing intervention in invasive blood pressure monitoring of critically ill patients. Methods: A total of 56 patients who underwent invasive blood pressure monitoring from August 2020 to November 2021 were included and divided into a control group and a research group. The application effect of positive pressure infusion joint combined with cluster nursing intervention was analyzed. Results: The use of positive pressure infusion joint combined with bundle nursing measures in invasive blood pressure monitoring in patients with severe trauma had a significant effect on improving the physical and mental state of patients, and further optimized the incidence of complications (P < 0.05). Based on the development of cluster nursing measures, the emotional state of patients with severe trauma at the stage of invasive blood pressure monitoring was effectively improved, and the further implementation of related nursing content better optimized the adverse emotions of patients with anxiety and depression (P < 0.05). The development of positive pressure infusion joint combined with cluster nursing measures has important value in improving patients condition, further optimizing the efficiency of disease intervention, and promoting the improvement effect of patients physiological state (P < 0.05). Through the analysis of blood pressure and heart rate index data in the monitoring stage, the research results better confirmed that the development of positive pressure infusion joint combined with cluster nursing measures has a good value in improving patients heart rate and blood pressure indicators (P < 0.05);Cluster nursing measures combined with positive pressure infusion joint can further improve the quality of life of patients with severe blood pressure monitoring. Through the intervention of the condition and the targeted implementation of nursing quality, the quality of life score of patients is effectively optimized (P < 0.05). Discussion: In the stage of invasive blood pressure monitoring for critically ill patients, when positive pressure infusion joints are used, cluster nursing intervention measures should be jointly carried out, which can effectively guarantee the improvement of patients mood, optimize the quality of life after recovery, and improve rehabilitation efficiency, which has the value of promotion.展开更多
In order to do a good job in the treatment and nursing of critically ill patients in ICU, the application effect of invasive arterial blood pressure monitoring method was investigated. This time, a total of 80 patient...In order to do a good job in the treatment and nursing of critically ill patients in ICU, the application effect of invasive arterial blood pressure monitoring method was investigated. This time, a total of 80 patients from May 2020 to May 2022 in a hospital were selected and reasonably divided into a control group and an observation group with the same number of patients. Patients in the control group were treated by invasive arterial blood pressure monitoring through radial artery puncture, and routine care was taken. On this basis, patients in the observation group were treated and studied by invasive arterial blood pressure monitoring through dorsum pedis artery puncture, and comprehensive care measures were taken. After a period of time, the two groups were compared in terms of complications, arterial cannula indwelling time and other aspects. Standing on the basis of one-time puncture operation, the observation composition power is significantly higher than that of the control group, and there is no hidden danger of various indwelling complications. In the observation group, the patients arterial cannula is indwelled for a long time, and all aspects are better than that of the control group, and there is significant difference in data comparison between the groups. It can be seen from this that, in order to do a good job in the treatment and nursing of critically ill patients in ICU, it is extremely critical to adopt invasive arterial blood pressure monitoring method through dorsal artery puncture. Compared with invasive arterial blood pressure monitoring method through radial artery puncture, it can control the occurrence of various complications as much as possible, at the same time, it can also improve the treatment effectiveness of patients, and fully increase the retention time of arterial cannula. It is worthy of all-round promotion and application in industry and life.展开更多
Objective: to study the effect of invasive arterial blood pressure monitoring in surgical anesthesia. Methods: clinical data of 96 surgical patients admitted to our hospital from July 2019 to December 2020 were retros...Objective: to study the effect of invasive arterial blood pressure monitoring in surgical anesthesia. Methods: clinical data of 96 surgical patients admitted to our hospital from July 2019 to December 2020 were retrospectively collected, all of whom received general anesthesia. Patients were randomly divided into experimental group (n=48) who received invasive intraoperative arterial blood pressure monitoring, and reference group (n=48) who received noninvasive intraoperative arterial blood pressure monitoring. Observation of intraoperative blood pressure monitoring, intraoperative anesthesia use, frequency of additional vasoactive drugs, operation termination rate, intraoperative blood volume insufficiency, hypoxemia, carbon dioxide retention, electrolyte, acid-base imbalance overall incidence, blood pressure monitoring results satisfaction. Results: there was no statistical difference in intraoperative SBP, DBP and MAP monitoring results between the two groups, P < 0.05;The anesthesia use times (1.02±0.31), the frequency of vasoactive drug addition times (1.01±0.16), the operation termination rate (0.00%), hypovolemia, hypoxemia, carbon dioxide retention, electrolyte, acid-base imbalance total incidence (4.65%) of the experimental group were lower than that of the reference group. The satisfaction of intraoperative blood pressure monitoring results in the experimental group (97.67%) was significantly higher than that in the reference group (P < 0.05). Conclusion: invasive arterial blood pressure monitoring in surgical anesthesia can timely, accurately and dynamically reflect the patient's hemodynamic status, and provide guarantee for the smooth operation.展开更多
Blood pressure is currently a very important tool for clinical and veterinary surgery, especially in monitoring patients under anesthesia and in emergency situations. Hypertension can cause a number of changes in the ...Blood pressure is currently a very important tool for clinical and veterinary surgery, especially in monitoring patients under anesthesia and in emergency situations. Hypertension can cause a number of changes in the body of dogs and cats, especially those who are middle-aged and elderly. In veterinary medicine, the blood pressure can be measured non-invasively and invasively. The non-invasive, or indirect technique, is frequently used during routine examinations since it presents convenience as it can be carried out quickly, although it is less accurate. For this research 245 dogs were selected, with one to ten years of age, of both sexes, castrated and uncastrated of different breeds and body scores. The dogs were weighed and had the body condition score determined using the system of 9 points, being categorized into: Control group, overweight group or obese group. Systolic blood pressure was obtained by non-invasive method using the Doppler flowmeter and the oscillometric method. 48 animals were excluded due to the high variability of values, with systolic blood pressure greater than 160 mm?Hg, as well as uncooperative and/or aggressive patients. There was agreement between both methods in 197 dogs conscious and asymptomatic and, therefore, this study showed that oscillometric method can be used in normotensive patients as the study was conducted in patients of different sizes, breeds, ages, body scores and sexual status.展开更多
BACKGROUND:Blood pressure(BP)monitoring is essential for patient care.Invasive arterial BP(IABP)is more accurate than non-invasive BP(NIBP),although the clinical signifi cance of this diff erence is unknown.We hypothe...BACKGROUND:Blood pressure(BP)monitoring is essential for patient care.Invasive arterial BP(IABP)is more accurate than non-invasive BP(NIBP),although the clinical signifi cance of this diff erence is unknown.We hypothesized that IABP would result in a change of management(COM)among patients with non-hypertensive diseases in the acute phase of resuscitation.METHODS:This prospective study included adults admitted to the Critical Care Resuscitation Unit(CCRU)with non-hypertensive disease from February 1,2019,to May 31,2021.Management plans to maintain a mean arterial pressure>65 mmHg(1 mmHg=0.133 kPa)were recorded in real time for both NIBP and IABP measurements.A COM was defined as a discrepancy between IABP and NIBP that resulted in an increase/decrease or addition/discontinuation of a medication/infusion.Classification and regression tree analysis identified significant variables associated with a COM and assigned relative variable importance(RVI)values.RESULTS:Among the 206 patients analyzed,a COM occurred in 94(45.6%[94/206])patients.The most common COM was an increase in current infusion dosages(40 patients,19.4%).Patients receiving norepinephrine at arterial cannulation were more likely to have a COM compared with those without(45[47.9%]vs.32[28.6%],P=0.004).Receiving norepinephrine(relative variable importance[RVI]100%)was the most signifi cant factor associated with a COM.No complications were identifi ed with IABP use.CONCLUSION:A COM occurred in 94(45.6%)non-hypertensive patients in the CCRU.Receiving vasopressors was the greatest factor associated with COM.Clinicians should consider IABP monitoring more often in non-hypertensive patients requiring norepinephrine in the acute resuscitation phase.Further studies are necessary to confi rm the risk-to-benefi t ratios of IABP among these high-risk patients.展开更多
Objective: observe the clinical effect of three kinds of minimally invasive surgery combined with traditional Chinese medicine in the treatment of lactation mammary abscess. Methods: 95 cases of mammary abscess in lac...Objective: observe the clinical effect of three kinds of minimally invasive surgery combined with traditional Chinese medicine in the treatment of lactation mammary abscess. Methods: 95 cases of mammary abscess in lactation were treated with internal and external application of Chinese medicine combined with puncture and abscess, minimally invasive negative pressure drainage and small incision drainage. Results: all cases healed smoothly. After 3-6 months of follow-up, lactation function was retained without breast fistula and no obvious breast deformation was observed. Conclusion: reasonable selection of ultrasound-guided puncture and abscess extraction, minimally invasive negative pressure drainage and small incision incision drainage can make the treatment of mammary abscess minimally invasive, safe, less painful, and has a good cosmetic effect.展开更多
Background Early withdraw from invasive mechanical ventilation （MV） followed by noninvasive MV is a new strategy for changing modes of treatment. This study was conducted to estimate the feasibility and the efficacy...Background Early withdraw from invasive mechanical ventilation （MV） followed by noninvasive MV is a new strategy for changing modes of treatment. This study was conducted to estimate the feasibility and the efficacy of early extubation and sequential noninvasive MV commenced at beginning of pulmonary infection control window in patients with exacerbated hypercapnic respiratory failure caused by chronic obstructive pulmonary diseases （ C OPD ）. Methods A prospective, randomized controlled study was conducted in eleven teaching hospitals＇ respiratory or medical intensive care units in China. Ninety intubated COPD patients with severe hypercapnic respiratory failure triggered by pulmonary infection （pneumonia or purulent bronchitis） were involved in the study. When the pulmonary infection had been controlled by antibiotics and comprehensive therapy, the “pulmonary infection control window （PIC window）” has been reached. Each case was randomly assigned to study group （extubation and noninvasive MV via facial mask immediately） or control group （ invasive MV was received continuously after PIC window by using conventional weaning technique）. Results Study group （n = 47 ） and control group （n = 43 ） had similar clinical characteristics initially and at the time of PIC window. Compared with control group, study group had shorter duration of invasive MV [ （6. 4±4. 4） days vs （ 11.3±6. 2） days, P =0. 0001, lower rate of ventilator associated pneumonia （VAP） （3/47 vs 12/43, P=0.014）, fewer days in ICU [（12 ＋8） days vs 16 ＋ 11） days, P =0.047] and lower hospital mortality （ 1/47 vs 7/43, P =0. 025）. Conclusions In COPD patients requiring intubation and lnvasive MV for hypercapnic respiratory failure, which is exacerbated by pulmonary infection, early extubation followed by noninvasive MV initiated at the start of PIC window may decrease significantly the duration of invasive MV, the risk of VAP and hospital mortality.展开更多
文摘Objective: The objective is to investigate the incidence and consequences of arterial line occlusion during invasive blood pressure monitoring in the form of questionnaire survey. Methods: The questionnaires were randomly distributed to the anesthesiologists who participated the 22<sup>nd</sup> annual meeting of Chinese society of anesthesiology. The main contents of this survey included the arterial line managing status, the incidence of arterial line occlusion, the effects of arterial line occlusion on the anesthesiologists’ therapy and consequences caused by arterial line occlusion. Results: Totally 294 questionnaires were collected, in which 261 questionnaires were valid. In all respondents, 28.3% expressed that they could not flush arterial line on time, and 95.4% had experienced flushing arterial line only or sometimes or occasionally when the arterial waveform was not normal. Furthermore, 93.9% had experienced partial occlusion of the arterial line, and 79.3% had experienced complete occlusion. According to the serious recall of the respondents, the incidence of partial arterial line occlusion was 17.7% ± 22.0%, and the incidence of complete arterial line occlusion was 3.6% ± 8.1%. For all the respondents, 89.7% had experienced suspecting arterial line occlusion while real hypotension occurred, 65.1% had experienced not treating hypotension timely due to this suspicion, and 31% had experienced serious consequences caused by this suspicion. Conclusion: The incidence of arterial line occlusion is high during invasive blood pressure monitoring, which is a threat to the patients’ safety. So, intensive attention should be paid to the arterial line management.
文摘Objective: To study the clinical value of positive pressure infusion joint combined with cluster nursing intervention in invasive blood pressure monitoring of critically ill patients. Methods: A total of 56 patients who underwent invasive blood pressure monitoring from August 2020 to November 2021 were included and divided into a control group and a research group. The application effect of positive pressure infusion joint combined with cluster nursing intervention was analyzed. Results: The use of positive pressure infusion joint combined with bundle nursing measures in invasive blood pressure monitoring in patients with severe trauma had a significant effect on improving the physical and mental state of patients, and further optimized the incidence of complications (P < 0.05). Based on the development of cluster nursing measures, the emotional state of patients with severe trauma at the stage of invasive blood pressure monitoring was effectively improved, and the further implementation of related nursing content better optimized the adverse emotions of patients with anxiety and depression (P < 0.05). The development of positive pressure infusion joint combined with cluster nursing measures has important value in improving patients condition, further optimizing the efficiency of disease intervention, and promoting the improvement effect of patients physiological state (P < 0.05). Through the analysis of blood pressure and heart rate index data in the monitoring stage, the research results better confirmed that the development of positive pressure infusion joint combined with cluster nursing measures has a good value in improving patients heart rate and blood pressure indicators (P < 0.05);Cluster nursing measures combined with positive pressure infusion joint can further improve the quality of life of patients with severe blood pressure monitoring. Through the intervention of the condition and the targeted implementation of nursing quality, the quality of life score of patients is effectively optimized (P < 0.05). Discussion: In the stage of invasive blood pressure monitoring for critically ill patients, when positive pressure infusion joints are used, cluster nursing intervention measures should be jointly carried out, which can effectively guarantee the improvement of patients mood, optimize the quality of life after recovery, and improve rehabilitation efficiency, which has the value of promotion.
文摘In order to do a good job in the treatment and nursing of critically ill patients in ICU, the application effect of invasive arterial blood pressure monitoring method was investigated. This time, a total of 80 patients from May 2020 to May 2022 in a hospital were selected and reasonably divided into a control group and an observation group with the same number of patients. Patients in the control group were treated by invasive arterial blood pressure monitoring through radial artery puncture, and routine care was taken. On this basis, patients in the observation group were treated and studied by invasive arterial blood pressure monitoring through dorsum pedis artery puncture, and comprehensive care measures were taken. After a period of time, the two groups were compared in terms of complications, arterial cannula indwelling time and other aspects. Standing on the basis of one-time puncture operation, the observation composition power is significantly higher than that of the control group, and there is no hidden danger of various indwelling complications. In the observation group, the patients arterial cannula is indwelled for a long time, and all aspects are better than that of the control group, and there is significant difference in data comparison between the groups. It can be seen from this that, in order to do a good job in the treatment and nursing of critically ill patients in ICU, it is extremely critical to adopt invasive arterial blood pressure monitoring method through dorsal artery puncture. Compared with invasive arterial blood pressure monitoring method through radial artery puncture, it can control the occurrence of various complications as much as possible, at the same time, it can also improve the treatment effectiveness of patients, and fully increase the retention time of arterial cannula. It is worthy of all-round promotion and application in industry and life.
文摘Objective: to study the effect of invasive arterial blood pressure monitoring in surgical anesthesia. Methods: clinical data of 96 surgical patients admitted to our hospital from July 2019 to December 2020 were retrospectively collected, all of whom received general anesthesia. Patients were randomly divided into experimental group (n=48) who received invasive intraoperative arterial blood pressure monitoring, and reference group (n=48) who received noninvasive intraoperative arterial blood pressure monitoring. Observation of intraoperative blood pressure monitoring, intraoperative anesthesia use, frequency of additional vasoactive drugs, operation termination rate, intraoperative blood volume insufficiency, hypoxemia, carbon dioxide retention, electrolyte, acid-base imbalance overall incidence, blood pressure monitoring results satisfaction. Results: there was no statistical difference in intraoperative SBP, DBP and MAP monitoring results between the two groups, P < 0.05;The anesthesia use times (1.02±0.31), the frequency of vasoactive drug addition times (1.01±0.16), the operation termination rate (0.00%), hypovolemia, hypoxemia, carbon dioxide retention, electrolyte, acid-base imbalance total incidence (4.65%) of the experimental group were lower than that of the reference group. The satisfaction of intraoperative blood pressure monitoring results in the experimental group (97.67%) was significantly higher than that in the reference group (P < 0.05). Conclusion: invasive arterial blood pressure monitoring in surgical anesthesia can timely, accurately and dynamically reflect the patient's hemodynamic status, and provide guarantee for the smooth operation.
基金Araucaria Foundation(931/2013)for project financing and the granting of Scientific Initiation Scholarships.
文摘Blood pressure is currently a very important tool for clinical and veterinary surgery, especially in monitoring patients under anesthesia and in emergency situations. Hypertension can cause a number of changes in the body of dogs and cats, especially those who are middle-aged and elderly. In veterinary medicine, the blood pressure can be measured non-invasively and invasively. The non-invasive, or indirect technique, is frequently used during routine examinations since it presents convenience as it can be carried out quickly, although it is less accurate. For this research 245 dogs were selected, with one to ten years of age, of both sexes, castrated and uncastrated of different breeds and body scores. The dogs were weighed and had the body condition score determined using the system of 9 points, being categorized into: Control group, overweight group or obese group. Systolic blood pressure was obtained by non-invasive method using the Doppler flowmeter and the oscillometric method. 48 animals were excluded due to the high variability of values, with systolic blood pressure greater than 160 mm?Hg, as well as uncooperative and/or aggressive patients. There was agreement between both methods in 197 dogs conscious and asymptomatic and, therefore, this study showed that oscillometric method can be used in normotensive patients as the study was conducted in patients of different sizes, breeds, ages, body scores and sexual status.
文摘BACKGROUND:Blood pressure(BP)monitoring is essential for patient care.Invasive arterial BP(IABP)is more accurate than non-invasive BP(NIBP),although the clinical signifi cance of this diff erence is unknown.We hypothesized that IABP would result in a change of management(COM)among patients with non-hypertensive diseases in the acute phase of resuscitation.METHODS:This prospective study included adults admitted to the Critical Care Resuscitation Unit(CCRU)with non-hypertensive disease from February 1,2019,to May 31,2021.Management plans to maintain a mean arterial pressure>65 mmHg(1 mmHg=0.133 kPa)were recorded in real time for both NIBP and IABP measurements.A COM was defined as a discrepancy between IABP and NIBP that resulted in an increase/decrease or addition/discontinuation of a medication/infusion.Classification and regression tree analysis identified significant variables associated with a COM and assigned relative variable importance(RVI)values.RESULTS:Among the 206 patients analyzed,a COM occurred in 94(45.6%[94/206])patients.The most common COM was an increase in current infusion dosages(40 patients,19.4%).Patients receiving norepinephrine at arterial cannulation were more likely to have a COM compared with those without(45[47.9%]vs.32[28.6%],P=0.004).Receiving norepinephrine(relative variable importance[RVI]100%)was the most signifi cant factor associated with a COM.No complications were identifi ed with IABP use.CONCLUSION:A COM occurred in 94(45.6%)non-hypertensive patients in the CCRU.Receiving vasopressors was the greatest factor associated with COM.Clinicians should consider IABP monitoring more often in non-hypertensive patients requiring norepinephrine in the acute resuscitation phase.Further studies are necessary to confi rm the risk-to-benefi t ratios of IABP among these high-risk patients.
文摘Objective: observe the clinical effect of three kinds of minimally invasive surgery combined with traditional Chinese medicine in the treatment of lactation mammary abscess. Methods: 95 cases of mammary abscess in lactation were treated with internal and external application of Chinese medicine combined with puncture and abscess, minimally invasive negative pressure drainage and small incision drainage. Results: all cases healed smoothly. After 3-6 months of follow-up, lactation function was retained without breast fistula and no obvious breast deformation was observed. Conclusion: reasonable selection of ultrasound-guided puncture and abscess extraction, minimally invasive negative pressure drainage and small incision incision drainage can make the treatment of mammary abscess minimally invasive, safe, less painful, and has a good cosmetic effect.
文摘Background Early withdraw from invasive mechanical ventilation （MV） followed by noninvasive MV is a new strategy for changing modes of treatment. This study was conducted to estimate the feasibility and the efficacy of early extubation and sequential noninvasive MV commenced at beginning of pulmonary infection control window in patients with exacerbated hypercapnic respiratory failure caused by chronic obstructive pulmonary diseases （ C OPD ）. Methods A prospective, randomized controlled study was conducted in eleven teaching hospitals＇ respiratory or medical intensive care units in China. Ninety intubated COPD patients with severe hypercapnic respiratory failure triggered by pulmonary infection （pneumonia or purulent bronchitis） were involved in the study. When the pulmonary infection had been controlled by antibiotics and comprehensive therapy, the “pulmonary infection control window （PIC window）” has been reached. Each case was randomly assigned to study group （extubation and noninvasive MV via facial mask immediately） or control group （ invasive MV was received continuously after PIC window by using conventional weaning technique）. Results Study group （n = 47 ） and control group （n = 43 ） had similar clinical characteristics initially and at the time of PIC window. Compared with control group, study group had shorter duration of invasive MV [ （6. 4±4. 4） days vs （ 11.3±6. 2） days, P =0. 0001, lower rate of ventilator associated pneumonia （VAP） （3/47 vs 12/43, P=0.014）, fewer days in ICU [（12 ＋8） days vs 16 ＋ 11） days, P =0.047] and lower hospital mortality （ 1/47 vs 7/43, P =0. 025）. Conclusions In COPD patients requiring intubation and lnvasive MV for hypercapnic respiratory failure, which is exacerbated by pulmonary infection, early extubation followed by noninvasive MV initiated at the start of PIC window may decrease significantly the duration of invasive MV, the risk of VAP and hospital mortality.
