1.Application of specialized nursing care-led MDT model in early-stage ICU hyperbaric oxygen treatment after aortic dissection surgery
Chaoqun TU ; Jun LI ; Xu CHEN ; Biru ZENG ; Liuli ZHANG ; Wenqing CHEN ; Wenhao CHEN ; Ying LONG
Chinese journal of nautical medicine and hyperbaric medicine 2022;29(3):345-349
Objective:To explore the effect of applying the multi-disciplinary team(MDT)model led by specialized nursing care in the treatment carried out at early stage in intensive care unit of hyperbaric oxygen(ICU-HBO)for patients with brain complications after Stanford type A aortic dissection(AD)surgery.Method:From January 2018 to December 2020,a total of 18 patients with brain complications after AD surgery were included and treated by ICU-HBO with MDT model. The patients’ ventilator tolerance and weaning time,outcome,occurrence of adverse events,and satisfaction rate of nursing care were observed.Results:(1)Fifteen mechanically ventilated patients were successfully weaned off the machine after 1-5 times of ICU-HBO treatment.(2)Sixteen patients regained their consciousness to the normal level after 2-13 times of ICU-HBO treatments,with the total effective rate of 88.89%;two patients in persistent vegetative state(deep coma)discontinued the treatment after two times of ICU-HBO treatments as their family gave up. During the follow-up period of six months to two years,11 cases were found clinically cured,one case was considered effective,four cases lost contact,and the two cases that had gave up treatment died of complications.(3)No adverse medical event(related to safety)occurred during the ICU-HBO treatment.(4)The satisfaction rate of nursing care was 100%.Conclusion:In the early ICU-HBO treatment of patients with brain complications after Stanford type A AD surgery,the application of MDT mode led by specialized nursing care is beneficial to the treatment risk control,ensure the treatment effectiveness,and improve the long-term prognosis,and quality of life of AD patients.
2.Application of specialized nursing care-led MDT model in early-stage ICU hyperbaric oxygen treatment after aortic dissection surgery
Chaoqun TU ; Jun LI ; Xu CHEN ; Biru ZENG ; Liuli ZHANG ; Wenqing CHEN ; Wenhao CHEN ; Ying LONG
Chinese journal of nautical medicine and hyperbaric medicine 2022;29(3):345-349
Objective:To explore the effect of applying the multi-disciplinary team(MDT)model led by specialized nursing care in the treatment carried out at early stage in intensive care unit of hyperbaric oxygen(ICU-HBO)for patients with brain complications after Stanford type A aortic dissection(AD)surgery.Method:From January 2018 to December 2020,a total of 18 patients with brain complications after AD surgery were included and treated by ICU-HBO with MDT model. The patients’ ventilator tolerance and weaning time,outcome,occurrence of adverse events,and satisfaction rate of nursing care were observed.Results:(1)Fifteen mechanically ventilated patients were successfully weaned off the machine after 1-5 times of ICU-HBO treatment.(2)Sixteen patients regained their consciousness to the normal level after 2-13 times of ICU-HBO treatments,with the total effective rate of 88.89%;two patients in persistent vegetative state(deep coma)discontinued the treatment after two times of ICU-HBO treatments as their family gave up. During the follow-up period of six months to two years,11 cases were found clinically cured,one case was considered effective,four cases lost contact,and the two cases that had gave up treatment died of complications.(3)No adverse medical event(related to safety)occurred during the ICU-HBO treatment.(4)The satisfaction rate of nursing care was 100%.Conclusion:In the early ICU-HBO treatment of patients with brain complications after Stanford type A AD surgery,the application of MDT mode led by specialized nursing care is beneficial to the treatment risk control,ensure the treatment effectiveness,and improve the long-term prognosis,and quality of life of AD patients.
3.Risk evaluation and nursing strategies of gastric tube of patients after open heart surgery
Yun LI ; Daoru WEI ; Haiyan LIU ; Biru ZENG
Chinese Journal of Modern Nursing 2014;20(14):1680-1682
Objective Using the evaluation and analysis of nursing risk of the patients with gastric tube after open-heart surgery , to formulate corresponding nursing strategies in order to insure patients'safety. Methods A total of 316 patients with gastric tube after open heart surgery were examined and evaluated by each nursing risks.Results A total of 316 patients with gastric tube had no adverse events , with good nursing outcomes.Conclusions By evaluation and analysis the nursing risk of the patients with gastric tube after open-heart surgery, it is possible to reduce and avoid harmful events and insure patients'safety.
4.Clinical features and emergency management of severe encephalitis and neurogenic pulmonary edema caused by enterovirus type 71 in children
Yuncai ZHANG ; Xingwang LI ; Xiaodong ZHU ; Suyun QIAN ; Jiansheng ZENG ; Yunxiao SHANG ; Biru LIU ; Xiaolin LIU ; Xiangui RAN
Chinese Journal of Emergency Medicine 2008;17(12):1250-1254
Objective To investigate the clinical characteristics and emergency management of severe hand-foot-mouth disease(HFMD)associated with encephalitis and neurogenic pulmonary edema(NPE)caused by en-terovirus 71(EV71)in children.Method Data of critical patients with severe HFMD associated with encephalitis and NPE admitted to pediatric intensive care unit(PICU)Fuyan city Hospitals Anhni Province from May to June 2008 were reviewed.Results Of 30 patients,the mean age was 15.8 months ranged from 4 months to 48 months.The overall morality was 19.4%.Tha average duration of critical symptoms persisted Was 2.1 days ranged from 12 hours to 5 days.There were no rash found in 12 patients(33.3%).The chinical features of nervous system mani-fested the symptoms of brainstem encephalitis in 27 patients(75%),brainstem encephalitis with myelitis in 6 pa-tients(16.7%),and encephalitis in 3 patients(8.3%).The frothy expectoration tinged with pink or bloody,asyrmmetrical pulmonary edema or hemoptysis were the main features of NPE.The main approaches to the treatment were mechanical ventilation,mannitol,methylpredifiselone,intravenous immunoglobulin(IVIG),and vasoactive a-gents.And nine patients(25%)needed fluid volume resuscitation in addition.Conclusions Young children are particularly vulnerable to the Severe EV71 encephalitis with NPE.The majority of involved fatal patients are aged under 3 years.Patients may die of acute onset of NPE and/or hemoptysis with rapid progress towards cardiopul-monary failure.Early diagnosis and evaluation,respiratory support,lowering intracranial pressure and maintaining hemodynamics ale the essential therapeutic approaches.

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