1.Clinical significance of NT-proBNP in evaluation of cardiac function in patients with severe burn
Zhibin HUANG ; Wupeng CHEN ; Yubin HUANG ; Bingsheng PENG ; Jian HU ; Hui LIU
The Journal of Practical Medicine 2017;33(12):1989-1992
Objective To explore the clinical significance of N-terminal pro-brain natriuretic peptide(NT-proBNP)in the evaluation of cardiac function in patients with severe burns. Methods A total of 78 patients with severe burns in intensive care unit(ICU)in our hospital were selected. Patients were divided into a heart failure group(n = 31)and a non-heart failure group(n = 47)according to the heart failure complication condition. The changes of NT-proBNP level in different time ,heart function index ,relevant index and mortality were compared between the two groups. Results The levels of NT-proBNP ,troponin(CTnT),creatine kinase(CK),creatine kinase isoenzyme (CK-MB),stroke volume index (SVI),cardiac index (CI) and central venous pressure (CVP),and the score of acute physiologic and chronic health conditions(APACHE II)in the heart failure group were shown to be significantly increased than those of the non-heart failure group (P < 0.05). The mean arterial pressure(MAP)in the heart failure group was significantly lower than the non-heart failure group(P < 0.05). Mortality rate in the heart failure group was shown to be significantly higher than the non-heart failure group (P < 0.05). Conclusion Heart failure is a common complication in patients with severe burns. The mortality rate in the population with heart failure is relatively high ,for which NT-proBNP can effectively assess the conditions and prognosis.
2.Effect of the bed step training machine in the early pulmonary rehabilitation activities of mechanical ventilation patients
Wupeng XUE ; Wenjing WU ; Jiaqi CHEN ; Shan ZHANG
Chinese Journal of Practical Nursing 2020;36(32):2497-2500
Objective:To explore the effect of applying bed step training machine to carry out lower limb function exercise in the early lung rehabilitation activities of mechanical ventilation patients.Methods:The mechanical ventilation time of ≥24h, Acute Physiology and Chronic Health Score (APACHE-II) was selected from February 2019 to August 2019 in the Intensive Care Medicine Department of Shanxi Bethune Hospital, and 64 patients were selected with scores of ≥8 points, giving the step-stepping machine function exercise. Compared changes in heart rate, blood pressure, SpO 2 and ventilator support parameters before and after functional exercise (FiO 2, VT, Rate, PEEP, PS, oxygenation index, rapid shallow breath index). Results:The difference in heart rate, blood pressure, SpO 2 of patients before and after exercise of lower limb function was not statistically significant ( P>0.05). In the ventilator support parameters, FiO 2, VT, oxygenation index, rapid shallow breath index before exercise were (57.19±4.36) %, (421.22±17.31) ml, (172.75± 40.13) mmHg (1 mmHg=0.133 kPa), (47.28±3.89) times·min -1·L -1, after exercise were (49.67±5.82) %, (458.79±15.20) ml, (193.58±32.73) mmHg, (44.03±1.21) times·min -1·L -1, the difference was statistically significant ( t values were 1.389 -5.662, P <0.01 or 0.05).The difference of strain of rate, PEEP, and PS were not statistically significant ( P >0.05). Conclusions:Applying bed step training machine to carry out lower limb function exercise is an effective exercise method in the early Pulmonary Rehabilitation activities of mechanical ventilation patients. This method can make the oxygen concentration support parameters of the ventilator drop, the VT increases, increase patients' self-breathing, the oxygenation index increases, Rapid Shallow Breath Index decreases, and provides a prerequisite for shortening the mechanical ventilation time and going offline as soon as possible.