Objective: to explore the nursing effect of applying prone ventilation in ICU patients with respiratory failure. Methods: 80 patients with respiratory failure in ICU of our hospital from January 2019 to June 2020 were...Objective: to explore the nursing effect of applying prone ventilation in ICU patients with respiratory failure. Methods: 80 patients with respiratory failure in ICU of our hospital from January 2019 to June 2020 were randomly divided into two groups by envelope method. The control group was given routine intervention, and the experimental group was carried out prone ventilation nursing. PaCO2 levels, PaO2/ FiO2, length of hospital stay, total effective rate and incidence of complications were compared between the two groups at 1, 6, 12 and 24 hours after treatment. Results: the level of PaCO2, PaO2/ FiO2 in the experimental group at 1, 6, 12 and 24 hours after treatment was lower than that in the control group, the length of hospital stay was shorter than that in the control group, and the total effective rate was higher than that in the control group, with significant differences (P < 0.05). The complication rate of the observation group was compared with that of the control group (P BBB 0 0.05). Conclusion: nursing of respiratory failure patients in ICU with prone ventilation can effectively improve the blood gas index of patients, improve the treatment effect, shorten the length of hospitalization, and do not increase complications, which is worthy of promotion.展开更多
Objective:To investigate the effects of prone ventilation in patients with severe traumatic brain injury combined with pulmonary infection.Methods:A total of 100 patients with severe traumatic brain injury combined wi...Objective:To investigate the effects of prone ventilation in patients with severe traumatic brain injury combined with pulmonary infection.Methods:A total of 100 patients with severe traumatic brain injury combined with pulmonary infection in the hospital were randomly divided into a prone ventilation group and a conventional ventilation group,with 50 patients in each group.The Glasgow Coma Scale(GCS)score,APACHE II score,sputum culture results,oxygenation indicators,and prognosis were compared between the two groups.Data were processed using SPSS 25.0 statistical software,and t-tests and chi-square tests were used to compare continuous and categorical variables,respectively.Results:The experimental group showed better oxygenation indicators,a lower positive rate of sputum cultures,and reduced intracranial pressure compared to the control group(all P<0.05).Multivariate Cox regression analysis indicated that GCS score,APACHE II score,and prone ventilation were independent risk factors affecting patient prognosis(all P<0.05).Conclusion:Prone ventilation can improve oxygenation,reduce the risk of pulmonary infection,and decrease intracranial pressure in patients with severe traumatic brain injury combined with pulmonary infection,thereby improving patient prognosis.GCS score and APACHE II score can serve as important indicators for prognostic evaluation.展开更多
<strong>Background:</strong> Prone positioning is nowadays considered as one of the most effective strategies for patients with severe acute respiratory distress syndrome (ARDS). Prone position ventilation...<strong>Background:</strong> Prone positioning is nowadays considered as one of the most effective strategies for patients with severe acute respiratory distress syndrome (ARDS). Prone position ventilation can lead to some severe complications. Effectively implement prone ventilation and reduce the incidence of complications become an important problem for clinical medical staff. <strong>Aims: </strong>To investigate whether the Sandwich rolling over method was convenient for clinical implementation and can reduce complications. <strong>Design:</strong> This is a single-center, retrospective, observational study.<strong> Results:</strong> The mean pronation cycles per patient were 6.11 <span style="white-space:nowrap;">±</span> 4.40. The mean time spent in prone position for each cycle was 10.05 <span style="white-space:nowrap;">±</span> 4.42 hours. Two patients developed a pressure sore and the positions were cheek, auricle and chest. The mean time it took from preparation to cover the patient with the quilt was 10.56 <span style="white-space:nowrap;">±</span> 4.35 minutes. Conclusions: This retrospective study has shown that under the close cooperation and supervision of the team, the implementation efficiency of prone position ventilation can be improved and the occurrence of complications can be reduced.展开更多
Objective: to evaluate the effect of supine ventilation nursing on respiratory indexes of patients with respiratory failure in ICU. Methods: a total of 86 selected subjects were randomly divided into two groups: gener...Objective: to evaluate the effect of supine ventilation nursing on respiratory indexes of patients with respiratory failure in ICU. Methods: a total of 86 selected subjects were randomly divided into two groups: general group (43) and study group (43), and the nursing effect was analyzed. Results: after treatment, satisfaction, blood gas index, respiratory rate and heart rate of patients in study group were better than those in general group (P < 0.05). Conclusion: the effect of prone position ventilation nursing intervention in patients with respiratory failure is significant, and it is worth promoting.展开更多
BACKGROUND A major cause of mortality in the coronavirus disease 2019(COVID-19)pandemic was acute respiratory distress syndrome(ARDS).Currently,moderate to severe ARDS induced by COVID-19(COVID ARDS)and other viral an...BACKGROUND A major cause of mortality in the coronavirus disease 2019(COVID-19)pandemic was acute respiratory distress syndrome(ARDS).Currently,moderate to severe ARDS induced by COVID-19(COVID ARDS)and other viral and non-viral etiologies are treated by traditional ARDS protocols that recommend 12-16 hours of prone position ventilation(PPV)with neuromuscular blocking agents(NMBA)and a trial of inhaled vasodilators(IVd)if oxygenation does not improve.However,debate on the efficacy of adjuncts to PPV and low tidal volume ventilation persists and evidence about the benefits of IVd/NMBA in COVID ARDS is sparse.In our multi-center retrospective review,we evaluated the impact of PPV,IVd,and NMBA on outcomes and lung mechanics in COVID ARDS patients with moderate to severe ARDS.AIM To evaluate the impact of PPV used alone or in combination with pulmonary IVd and/or NMBA in mechanically ventilated patients with moderate to severe ARDS during the COVID-19 pandemic.METHODS A retrospective study at two tertiary academic medical centers compared outcomes between COVID ARDS patients receiving PPV and patients in the supine position.PPV patients were divided based on concurrent use of ARDS adjunct therapies resulting in four subgroups:(1)PPV alone;(2)PPV and IVd;(3)PPV and NMBA;and(4)PPV,IVd,and NMBA.Primary outcomes were hospital and intensive care unit(ICU)length of stay(LOS),mortality,and venovenous extracorporeal membrane oxygenation(VV-ECMO)status.Secondary outcomes included changes in lung mechanics at 24-hour intervals for 7 days.RESULTS Total 114 patients were included in this study.Baseline respiratory parameters and Sequential Organ Failure Assessment scores were significantly worse in the PPV group.ICU LOS and LOS were significantly longer for patients who were proned,but no mortality benefit or difference in VV-ECMO status was found.Among the subgroups,no difference in primary outcomes were found.In the secondary analysis,PPV was associated with a significant improvement in arterial oxygen partial pressure(PaO_(2))/fractional inspired oxygen(FiO_(2))(P/F)ratio from day 1 to day 4(P<0.05)and higher driving pressures day 5 to day 7(P<0.05).The combination of PPV and IVd together resulted in improvements in P/F ratio from day 1 to day 7 and plateau pressure on day 4 and day 6(P<0.05).PPV with NMBA was not associated with improvements in any of the secondary outcomes.The use of all three rescue therapies together resulted in improvements in lung compliance on day 2(P<0.05)but no other improvements.CONCLUSION In mechanically ventilated patients diagnosed with moderate to severe COVID ARDS,PPV and PPV with the addition of IVd produced a significant and sustained increase in P/F ratio.The combination of PPV,IVd and NMBA improved compliance however this did not reach significance.Mortality and LOS did not improve with adjunct therapies.Further research is warranted to determine the efficacy of these therapies alone and in combination in the treatment of COVID ARDS.展开更多
BACKGROUND A critically ill coronavirus disease 2019(COVID-19)patient complicated by acute respiratory distress syndrome is reported.The patient survived following treatment with awake veno-venous extracorporeal membr...BACKGROUND A critically ill coronavirus disease 2019(COVID-19)patient complicated by acute respiratory distress syndrome is reported.The patient survived following treatment with awake veno-venous extracorporeal membrane oxygenation(ECMO).CASE SUMMARY A 53-year-old male patient attended our hospital following a cough for 11 d and fever for 9 d.According to his computed tomography(CT)scan and real-time reverse transcription–polymerase chain reaction assay of a throat swab,nucleic acid was positive,confirming that he had COVID-19.He was subsequently transferred to the intensive care unit due to respiratory failure.The patient received antiviral drugs,a small dose of glucocorticoid,and respiratory support,including mechanical ventilation,but the treatment effect was poor.On the 28th day after admission,veno-venous ECMO and prone position ventilation(PPV)were performed,combined with awake ECMO and other comprehensive rehabilitation measures.On the 17th day of ECMO,the patient started to improve and his chest CT and lung compliance improved.ECMO was discontinued after 27 days,and mechanical ventilation was also discontinued after 9 days.The patient was then transferred to the rehabilitation department.CONCLUSION COVID-19 can damage lung tissues and cause evident inflammatory exudation,thus affecting oxygenation function.Awake ECMO,PPV,and comprehensive rehabilitation are effective in patients with critical COVID-19 and respiratory failure.展开更多
文摘Objective: to explore the nursing effect of applying prone ventilation in ICU patients with respiratory failure. Methods: 80 patients with respiratory failure in ICU of our hospital from January 2019 to June 2020 were randomly divided into two groups by envelope method. The control group was given routine intervention, and the experimental group was carried out prone ventilation nursing. PaCO2 levels, PaO2/ FiO2, length of hospital stay, total effective rate and incidence of complications were compared between the two groups at 1, 6, 12 and 24 hours after treatment. Results: the level of PaCO2, PaO2/ FiO2 in the experimental group at 1, 6, 12 and 24 hours after treatment was lower than that in the control group, the length of hospital stay was shorter than that in the control group, and the total effective rate was higher than that in the control group, with significant differences (P < 0.05). The complication rate of the observation group was compared with that of the control group (P BBB 0 0.05). Conclusion: nursing of respiratory failure patients in ICU with prone ventilation can effectively improve the blood gas index of patients, improve the treatment effect, shorten the length of hospitalization, and do not increase complications, which is worthy of promotion.
基金Research Project of the 900th Hospital of Joint Logistics Support Force(Project No.2020L30)。
文摘Objective:To investigate the effects of prone ventilation in patients with severe traumatic brain injury combined with pulmonary infection.Methods:A total of 100 patients with severe traumatic brain injury combined with pulmonary infection in the hospital were randomly divided into a prone ventilation group and a conventional ventilation group,with 50 patients in each group.The Glasgow Coma Scale(GCS)score,APACHE II score,sputum culture results,oxygenation indicators,and prognosis were compared between the two groups.Data were processed using SPSS 25.0 statistical software,and t-tests and chi-square tests were used to compare continuous and categorical variables,respectively.Results:The experimental group showed better oxygenation indicators,a lower positive rate of sputum cultures,and reduced intracranial pressure compared to the control group(all P<0.05).Multivariate Cox regression analysis indicated that GCS score,APACHE II score,and prone ventilation were independent risk factors affecting patient prognosis(all P<0.05).Conclusion:Prone ventilation can improve oxygenation,reduce the risk of pulmonary infection,and decrease intracranial pressure in patients with severe traumatic brain injury combined with pulmonary infection,thereby improving patient prognosis.GCS score and APACHE II score can serve as important indicators for prognostic evaluation.
文摘<strong>Background:</strong> Prone positioning is nowadays considered as one of the most effective strategies for patients with severe acute respiratory distress syndrome (ARDS). Prone position ventilation can lead to some severe complications. Effectively implement prone ventilation and reduce the incidence of complications become an important problem for clinical medical staff. <strong>Aims: </strong>To investigate whether the Sandwich rolling over method was convenient for clinical implementation and can reduce complications. <strong>Design:</strong> This is a single-center, retrospective, observational study.<strong> Results:</strong> The mean pronation cycles per patient were 6.11 <span style="white-space:nowrap;">±</span> 4.40. The mean time spent in prone position for each cycle was 10.05 <span style="white-space:nowrap;">±</span> 4.42 hours. Two patients developed a pressure sore and the positions were cheek, auricle and chest. The mean time it took from preparation to cover the patient with the quilt was 10.56 <span style="white-space:nowrap;">±</span> 4.35 minutes. Conclusions: This retrospective study has shown that under the close cooperation and supervision of the team, the implementation efficiency of prone position ventilation can be improved and the occurrence of complications can be reduced.
文摘Objective: to evaluate the effect of supine ventilation nursing on respiratory indexes of patients with respiratory failure in ICU. Methods: a total of 86 selected subjects were randomly divided into two groups: general group (43) and study group (43), and the nursing effect was analyzed. Results: after treatment, satisfaction, blood gas index, respiratory rate and heart rate of patients in study group were better than those in general group (P < 0.05). Conclusion: the effect of prone position ventilation nursing intervention in patients with respiratory failure is significant, and it is worth promoting.
文摘BACKGROUND A major cause of mortality in the coronavirus disease 2019(COVID-19)pandemic was acute respiratory distress syndrome(ARDS).Currently,moderate to severe ARDS induced by COVID-19(COVID ARDS)and other viral and non-viral etiologies are treated by traditional ARDS protocols that recommend 12-16 hours of prone position ventilation(PPV)with neuromuscular blocking agents(NMBA)and a trial of inhaled vasodilators(IVd)if oxygenation does not improve.However,debate on the efficacy of adjuncts to PPV and low tidal volume ventilation persists and evidence about the benefits of IVd/NMBA in COVID ARDS is sparse.In our multi-center retrospective review,we evaluated the impact of PPV,IVd,and NMBA on outcomes and lung mechanics in COVID ARDS patients with moderate to severe ARDS.AIM To evaluate the impact of PPV used alone or in combination with pulmonary IVd and/or NMBA in mechanically ventilated patients with moderate to severe ARDS during the COVID-19 pandemic.METHODS A retrospective study at two tertiary academic medical centers compared outcomes between COVID ARDS patients receiving PPV and patients in the supine position.PPV patients were divided based on concurrent use of ARDS adjunct therapies resulting in four subgroups:(1)PPV alone;(2)PPV and IVd;(3)PPV and NMBA;and(4)PPV,IVd,and NMBA.Primary outcomes were hospital and intensive care unit(ICU)length of stay(LOS),mortality,and venovenous extracorporeal membrane oxygenation(VV-ECMO)status.Secondary outcomes included changes in lung mechanics at 24-hour intervals for 7 days.RESULTS Total 114 patients were included in this study.Baseline respiratory parameters and Sequential Organ Failure Assessment scores were significantly worse in the PPV group.ICU LOS and LOS were significantly longer for patients who were proned,but no mortality benefit or difference in VV-ECMO status was found.Among the subgroups,no difference in primary outcomes were found.In the secondary analysis,PPV was associated with a significant improvement in arterial oxygen partial pressure(PaO_(2))/fractional inspired oxygen(FiO_(2))(P/F)ratio from day 1 to day 4(P<0.05)and higher driving pressures day 5 to day 7(P<0.05).The combination of PPV and IVd together resulted in improvements in P/F ratio from day 1 to day 7 and plateau pressure on day 4 and day 6(P<0.05).PPV with NMBA was not associated with improvements in any of the secondary outcomes.The use of all three rescue therapies together resulted in improvements in lung compliance on day 2(P<0.05)but no other improvements.CONCLUSION In mechanically ventilated patients diagnosed with moderate to severe COVID ARDS,PPV and PPV with the addition of IVd produced a significant and sustained increase in P/F ratio.The combination of PPV,IVd and NMBA improved compliance however this did not reach significance.Mortality and LOS did not improve with adjunct therapies.Further research is warranted to determine the efficacy of these therapies alone and in combination in the treatment of COVID ARDS.
文摘BACKGROUND A critically ill coronavirus disease 2019(COVID-19)patient complicated by acute respiratory distress syndrome is reported.The patient survived following treatment with awake veno-venous extracorporeal membrane oxygenation(ECMO).CASE SUMMARY A 53-year-old male patient attended our hospital following a cough for 11 d and fever for 9 d.According to his computed tomography(CT)scan and real-time reverse transcription–polymerase chain reaction assay of a throat swab,nucleic acid was positive,confirming that he had COVID-19.He was subsequently transferred to the intensive care unit due to respiratory failure.The patient received antiviral drugs,a small dose of glucocorticoid,and respiratory support,including mechanical ventilation,but the treatment effect was poor.On the 28th day after admission,veno-venous ECMO and prone position ventilation(PPV)were performed,combined with awake ECMO and other comprehensive rehabilitation measures.On the 17th day of ECMO,the patient started to improve and his chest CT and lung compliance improved.ECMO was discontinued after 27 days,and mechanical ventilation was also discontinued after 9 days.The patient was then transferred to the rehabilitation department.CONCLUSION COVID-19 can damage lung tissues and cause evident inflammatory exudation,thus affecting oxygenation function.Awake ECMO,PPV,and comprehensive rehabilitation are effective in patients with critical COVID-19 and respiratory failure.
