Preventive effect of airflow shock on micro-aspiration of patients with mechanical ventilation via endotracheal intubation
10.3760/cma.j.cn211501-20191031-03140
- VernacularTitle:气流冲击法对经口气管插管机械通气患者微误吸的预防效果研究
- Author:
Yanfei ZHU
1
;
Wenjing SONG
;
Yandi YANG
;
Ying WANG
;
Lin DOU
Author Information
1. 天津市第一中心医院重症医学科 300192
- From:
Chinese Journal of Practical Nursing
2020;36(19):1486-1490
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the preventive effect of airflow shock on micro-smoke in patients with mechanical ventilation through oral tracheal intubation.Methods:Using simple random sampling method, 76 patients who underwent mechanical ventilation through oral tracheal intubation in Tianjin First Central Hospital from March 2019 to August 2019 were selected as subjects. They were divided into two groups by the random number table method with 38 cases in each group. The observation group was treated with airflow shock method and intermittent glottic suction. The control group was treated with intermittent glottic suction. The total amount of retentate on the 24 h capsule and the suction tube on the capsule were compared. The incidence of catheter blockage, bacterial culture of the upper respiratory tract and lower respiratory tract secretion, ventilator-associated pneumonia (VAP) incidence rate, and changes in vital signs of patients before and after operation.Results:The incidence of VAP, the total amount of retentate on the 24 h capsule, the incidence of catheter blockage was 2.9% (1/34), (19.37 ± 5.52) ml, 17.6% (3/34) in the observation group, and 20.0% (7/35), (14.98 ± 3.77) ml, 25.7% (12/35) in the control group, the difference between the two groups was statistically significant ( χ2 values were 4.896, 7.239, t value was 5.315, P<0.05 or 0.01). The positive rate of pathogens in the sac retentate culture was 54.6% (113/207), 149 pathogens, the positive rate of lower respiratory tract secretion pathogen was 12.6% (26/207), and 37 pathogens. The pathogens of the two groups were similar. Gram-negative bacilli mainly, the main dominant bacteria were Acinetobacter baumannii, Pseudomonas aeruginosa and Stenotrophomonas maltophilia, and there was no significant difference in the ratio of the main pathogens in the sac retentate and lower respiratory tract secretions between the two groups ( P>0.05). There was no significant difference in heart rate, systolic blood pressure, diastolic blood pressure and respiratory changes between the two groups before and after operation ( P>0.05). Conclusions:The airflow impact method combined with the suction under the glottal can effectively remove the airbag wrinkles and the retentate accumulated on the capsule, which can reduce the incidence of suction tube obstruction on the capsule, prevent the occurrence of micro aspiration and reduce the incidence of VAP.
