The Way of Severe Nursing of Respiratory System Failure

Respiratory failure is the most common clinical symptom, seriously endangering people’s health, which is mainly caused by a series of reasons, leading to serious respiratory dysfunction and severe pulmonary respiratory disorders, damaging the pulmonary airway function, and causing disability to maintain normal human gas exchange activities. At present, the main treatment of respiratory failure is to use the ventilator to help patients exchange gas and keep their breathing unobstructed. The nursing method is also around the artificial airway mechanical ventilation. The nursing of patients with respiratory failure is mainly respiratory nursing and psychological nursing. In this paper, the main research is to explore the way of severe nursing of respiratory failure. Before the nursing of respiratory failure, we should carry out nursing detection of the ventilator and test its performance, tightness, pipeline safety, and airway patency. Then carrying on the respiratory failure mechanical ventilation nursing and clarifying its mechanical ventilation nursing process is the main work of intensive care, at the same time, giving consideration to the psychological nursing of respiratory failure and implementing comprehensive nursing. In this paper, 50 patients were selected and divided into group A and group B; group A was given comprehensive nursing, and group B was given general nursing. The experimental results show that a series of situations in group A are more optimistic than those in group B. There was no doubt that the PH value of the two groups changed significantly 6 months after discharge. The pO2 value of group A was higher than that before discharge, while the pCO2 value of group B was unstable and increased. The pO2 value of group A was 55.52 before discharge and 62.36 six months after discharge. The pCO2 value of group A was 54.31 before discharge and 50.61 six months after discharge. The pCO2 value of group B was 55.23 before discharge and 57.34 six months after discharge.

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Removal of Mechanical Ventilation During Veno-Venous ECMO May Improve Outcome of Patients with Acute Respiratory Failure Due to Adult Community-Acquired Pneumonia

10.21203/rs.3.rs-798903/v1 ◽

2021 ◽

Author(s):

Lu-Lu Li ◽

Cong-Ying Song ◽

Mei Shao ◽

An-Dong Shang ◽

Lin-Lin Meng ◽

...

Keyword(s):

Mechanical Ventilation ◽

Respiratory Failure ◽

Survival Rate ◽

Acute Respiratory Failure ◽

Demographic Data ◽

Community Acquired Pneumonia ◽

Significant Independent Predictor ◽

Group A ◽

Group B ◽

Ecmo Therapy

Abstract Background: As a life-saving therapy for patients with acute respiratory failure (ARF)Mechanical ventilation has catalyzed the development of modern emergency medicine and intensive care units.Another way to support respiratory or cardiac functions is extracorporeal membrane oxygenation (ECMO).Based on previous studies, the increased pre-ECMO time of mechanical ventilation is a significant independent predictor of the poorer outcome . Removal or maintaining of mechanical ventilation during ECMO is still debatable. Methods: We analyzed the clinical data of 23 patients veno-venous ECMO therapy with acute respiratory failure due to adult community-acquired pneumonia.They were divided into two groups: group A (removed of mechanical ventilation, n=10) and group B ( maintaining of mechanical ventilation,n=13).Demographic data, including gender, age, smoking habits were collected. General characteristics and Clinical characteristics of patients were also recorded, in order to discuss whether the retention or removal of trachea cannula and continued mechanical ventilation during ECMO can affect patients’ prognosis. Results: After analysis, patients in the Group B were older than the Group A (61.0 y [54.5-67.5] vs 39.0 y [24.0-61.8], P=0.021). The median APACHE Ⅱ score of 23 patients before ECMO therapy was 25.0 (IQR, 21.0-28.0), and the Group A had a lower initial APACHE Ⅱ score than the Group B (21.5 [20.8-24.3] vs 28.0 [24.0-29.0], P=0.005)(Table 1).The group A with a survival rate of 80% , and the group B presenting a survival rate of 23.1%.The difference in the survival rate between the two groups was statistically significant (P=0.012).No differences in other items were found between the two groups.Conclusions: The final results showed that the removing of mechanical ventilation during ECMO can improve the survival rate and prognosis in patients with ARF.

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Removal of mechanical ventilation during veno-venous ECMO may improve outcome of patients with acute respiratory failure due to adult community-acquired pneumonia

10.21203/rs.3.rs-798903/v2 ◽

2021 ◽

Author(s):

Lu-Lu Li ◽

Cong-Ying Song ◽

Mei Shao ◽

An-Dong Shang ◽

Lin-Lin Meng ◽

...

Keyword(s):

Mechanical Ventilation ◽

Respiratory Failure ◽

Survival Rate ◽

Acute Respiratory Failure ◽

Demographic Data ◽

Community Acquired Pneumonia ◽

Significant Independent Predictor ◽

Group A ◽

Group B ◽

Ecmo Therapy

Abstract Background As a life-saving therapy for patients with acute respiratory failure (ARF)Mechanical ventilation has catalyzed the development of modern emergency medicine and intensive care units.Another way to support respiratory or cardiac functions is extracorporeal membrane oxygenation (ECMO).Based on previous studies, the increased pre-ECMO time of mechanical ventilation is a significant independent predictor of the poorer outcome. Removal or maintaining of mechanical ventilation during ECMO is still debatable. Methods We analyzed the clinical data of 23 patients veno-venous ECMO therapy with acute respiratory failure due to adult community-acquired pneumonia.They were divided into two groups: group A (removed of mechanical ventilation, n = 10) and group B ( maintaining of mechanical ventilation,n = 13).Demographic data, including gender, age, smoking habits were collected. General characteristics and Clinical characteristics of patients were also recorded, in order to discuss whether the retention or removal of trachea cannula and continued mechanical ventilation during ECMO can affect patients’ prognosis. Results After analysis, patients in the Group B were older than the Group A (61.0 y [54.5–67.5] vs 39.0 y [24.0-61.8], P = 0.021). The median APACHE Ⅱ score of 23 patients before ECMO therapy was 25.0 (IQR, 21.0–28.0), and the Group A had a lower initial APACHE Ⅱ score than the Group B (21.5 [20.8–24.3] vs 28.0 [24.0–29.0], P = 0.005).The group A with a survival rate of 80%, and the group B presenting a survival rate of 23.1%.The difference in the survival rate between the two groups was statistically significant (P = 0.012).No differences in other items were found between the two groups. Conclusions The final results showed that the removing of mechanical ventilation during ECMO can improve the survival rate and prognosis in patients with ARF.

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Role of SatO2, PaO2/FiO2 Ratio and PaO2 to Predict Adverse Outcome in COVID-19: A Retrospective, Cohort Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182111534 ◽

2021 ◽

Vol 18 (21) ◽

pp. 11534

Author(s):

Stefano Sartini ◽

Laura Massobrio ◽

Ombretta Cutuli ◽

Paola Campodonico ◽

Cristina Bernini ◽

...

Keyword(s):

Respiratory Failure ◽

Adverse Outcome ◽

University Hospital ◽

Rt Pcr ◽

Threatening Condition ◽

Life Threatening ◽

Group A ◽

Group B ◽

The University

COVID-19 respiratory failure is a life-threatening condition. Oxygenation targets were evaluated in a non-ICU setting. In this retrospective, observational study, we enrolled all patients admitted to the University Hospital of Genoa, Italy, between 1 February and 31 May 2020 with an RT-PCR positive for SARS-CoV-2. PaO2, PaO2/FiO2 and SatO2% were collected and analyzed at time 0 and in case of admission, patients who required or not C-PAP (groups A and B) were categorized. Each measurement was correlated to adverse outcome. A total of 483 patients were enrolled, and 369 were admitted to hospital. Of these, 153 required C-PAP and 266 had an adverse outcome. Patients with PaO2 <60 and >100 had a higher rate of adverse outcome at time 0, in groups A and B (OR 2.52, 3.45, 2.01, respectively). About the PaO2/FiO2 ratio, the OR for < 300 was 3.10 at time 0, 4.01 in group A and 4.79 in group B. Similar odds were found for < 200 in any groups and < 100 except for group B (OR 11.57). SatO2 < 94% showed OR 1.34, 3.52 and 19.12 at time 0, in groups A and B, respectively. PaO2 < 60 and >100, SatO2 < 94% and PaO2/FiO2 ratio < 300 showed at least two- to three-fold correlation to adverse outcome. This may provide simple but clear targets for clinicians facing COVID-19 respiratory failure in a non ICU-setting.

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Intra-Abdominal Pressure as a Marker of Enteral Nutrition Intolerance in Critically Ill Patients. The PIANE Study

Nutrients ◽

10.3390/nu11112616 ◽

2019 ◽

Vol 11 (11) ◽

pp. 2616

Author(s):

M Bordejé ◽

Juan Montejo ◽

M Mateu ◽

Manuel Solera ◽

Jose Acosta ◽

...

Keyword(s):

Mechanical Ventilation ◽

Enteral Nutrition ◽

Critically Ill ◽

Critically Ill Patients ◽

Urinary Catheter ◽

Abdominal Pressure ◽

Icu Patients ◽

Group A ◽

Group B ◽

Low Sensitivity

To determine whether elevated intra-abdominal pressure (IAP) is associated with a higher rate of enteral nutrition-related gastrointestinal (GI) complications; to assess the value of IAP as a predictor of enteral nutrition (EN) intolerance. Intensive Care Unit (ICU) patients on mechanical ventilation requiring at least 5 days of EN were recruited for a prospective, observational, non-interventional, multicenter study. EN was performed and GI complications were managed with an established protocol. IAP was determined via a urinary catheter. Patients who developed any GI complications were considered as presenting EN intolerance. Variables related to EN, IAP and GI complications were monitored daily. Statistical analysis compared patients without GI complications (group A) vs. GI complications (group B). 247 patients were recruited from 28 participating ICUs (group A: 119, group B: 128). No differences between groups were recorded. Patients in group B (p < 0.001) spent more days on EN (8.1 ± 8.4 vs. 18.1 ± 13.7), on mechanical ventilation (8.0 ± 7.7 vs. 19.3 ± 14.9) and in the ICU (12.3 ± 11.4 vs. 24.8 ± 17.5). IAP prior to the GI complication was (14.3 ± 3.1 vs. 15.8 ± 4.8) (p < 0.003). The best IAP value identified for EN intolerance was 14 mmHg but it had low sensitivity and specificity. Although a higher IAP was associated with EN intolerance, IAP alone did not emerge as a good predictor of EN intolerance in critically ill patients.

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Teaching Games for Understanding: A Comprehensive Approach to Promote Student’s Motivation in Physical Education

Journal of Human Kinetics ◽

10.1515/hukin-2017-0144 ◽

2017 ◽

Vol 59 (1) ◽

pp. 17-27 ◽

Cited By ~ 8

Author(s):

David Hortigüela Alcalá ◽

Alejandra Hernando Garijo

Keyword(s):

Physical Education ◽

Sport Participation ◽

Traditional Approach ◽

Control Group ◽

Mixed Method Research ◽

Teaching Games For Understanding ◽

Group A ◽

Group B ◽

Motivation And Achievement ◽

The Way

AbstractIt seems important to consider students’ attitudes towards physical education (PE), and the way they learn sports. The present study examines students’ perceptions of motivation and achievement in PE after experiencing three consecutive sport units. Two hundred and thirty seven students from the 1st, 2nd, 3rd, and 4th grade in a high school in Burgos (Spain) and two teachers agreed to participate. They were divided into two groups in order to compare two instructional approaches. The experimental group (A), 128 students, experienced Teaching Games for Understanding (TGfU), while the control group (B), 109 students, experienced a technical-traditional approach. Each group was taught by a different teacher. The study followed a mixed-method research design with quantitative (questionnaire) and qualitative (interview) data. Results revealed that group A showed greater motivation and achievement in PE than group B. Significant differences were found in achievement. Participants with better academic results in group A were more positive in sport participation. Meanwhile, students who practiced more extracurricular sports in group B were more actively involved in sport. Teachers disagreed greatly on the way sport should be taught in PE.

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Electroacupuncture Reduces the Dose of Midazolam Monitored by the Bispectral Index in Critically Ill Patients with Mechanical Ventilation: An Exploratory Study

Acupuncture in Medicine ◽

10.1136/acupmed-2011-010095 ◽

2012 ◽

Vol 30 (2) ◽

pp. 78-84 ◽

Cited By ~ 14

Author(s):

Xia Zheng ◽

Jian-biao Meng ◽

Qiang Fang

Keyword(s):

Mechanical Ventilation ◽

Critically Ill ◽

Bispectral Index ◽

Critically Ill Patients ◽

Additional Treatment ◽

Acupuncture Points ◽

Sedative Drug ◽

Significant Difference ◽

Group A ◽

Group B

Objective Electroacupuncture, a modern variation on a traditional Chinese treatment, might be useful for sedation and analgesia. This study aims to investigate whether electroacupuncture can modify the dose of midazolam monitored by the bispectral index (BIS) in critically ill patients with mechanical ventilation. Methods Orotracheally intubated patients undergoing mechanical ventilation were randomly assigned into three groups (groups A, B and C). All patients were given an intravenous infusion of midazolam. Patients in group A received no additional treatment. Patients in group B were given acupuncture without electrical stimulation at acupuncture points GV24 and EX–HN3 ( Yintang) for 6 h simultaneously, and patients in group C were given electroacupuncture to the same points as in group B. Results Maintaining the BIS between 60 and 80, the hourly mean one dose of midazolam within the first 6 h after sedation in group C was 0.05 (±0.02 mg/kg per hour), which was significantly lower than both group A (0.08±0.03 mg/kg per hour, p<0.001) and group B (0.07±0.01 mg/kg per hour, p<0.021). The doses in groups A and B showed no significant difference. Between-group comparison analysis of hepatic and renal function and severe adverse reactions all showed no significant difference between the three groups. Conclusions Electroacupuncture appears to reduce markedly the dose of sedative drug required in critically ill patients with mechanical ventilation monitored by BIS, without any obvious severe adverse action, and larger studies to confirm the effect are justified.

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Comparison of Dexmedetomidine versus Midazolam in weaning from mechanical ventilation and length of stay in ICU.

The Professional Medical Journal ◽

10.29309/tpmj/2020.27.11.4535 ◽

2020 ◽

Vol 27 (11) ◽

pp. 2309-2313

Author(s):

Afia Arshed Dodhy

Keyword(s):

Mechanical Ventilation ◽

Intensive Care ◽

Length Of Stay ◽

Significant Relationship ◽

Controlled Trial ◽

Cost Study ◽

Extubation Time ◽

Group A ◽

Surgical Icu ◽

Group B

Objectives: To compare the role of dexmedetomidine versus midazolam as sedative in facilitating early mechanical ventilation weaning thereby decreasing ICU cost. Study Design: Randomized Controlled trial. Setting: Surgical ICU of Lahore General Hospital, Lahore. Period: December 2018 to July 2019. Material & Methods: Total of 60 adult postoperative patients (30 in each group) who required mechanical ventilation in the surgical ICU for minimum 24 hours postoperatively after major pelvi-abdominal operations were included. Patients of group “A” and “B” received midazolam infusion 20-100 mcg/kg/hr & dexmedetomidine infusion 0.2-0.7 μg/kg/hr respectively while being mechanically ventilated. The degree of sedation was measured by using the Richmond agitation sedation score (RASS) every 6 hourly. Extubation time (i.e. time from termination of drug to extubation) was recorded. The time of ICU length of stay was also recorded Results: Mean age of patients was 41.97 ±10.21 and 42.57±10.93 years in group-A and B, respectively. In group-A 18 patients (60%) and in group-B 16 patients (53.0%) were male while 12 patients (40%) in group-A and 14 patients (47.0%) were females. A significant decrease in extubation time was observed in Group-B when compared with the Group-A (p=0.046) along with odds ratio 0.938 while no significant relationship could be proved between length of stay at ICU between two groups. Stratification with regard to age, gender height, weight and type of surgery was carried out. Conclusion: Dexmedetomidine is more favourable than midazolam for sedation in intensive care patients by facilitating early exubation and decreasing the duration of invasive ventilation while no significant relationship could be proved in two groups between length of stay in intensive care unit.

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Clinical observation of alveolar surface active substances in the treatment of neonatal respiratory distress syndrome at different periods

10.21203/rs.2.13157/v1 ◽

2019 ◽

Author(s):

Han Han ◽

Xiao-xia Li ◽

Xiang-hua Shuai ◽

Zhi-qun Zhang ◽

Jing Li ◽

...

Keyword(s):

Mechanical Ventilation ◽

Rescue Therapy ◽

Total Duration ◽

Blood Gas Analysis ◽

Gas Analysis ◽

Blood Gas ◽

Systemic Hemodynamic ◽

Significant Difference ◽

Group A ◽

Group B

Abstract Background: Mechanical ventilation joint PS replacement therapy is an effective method in treatment of NRDS recognized, PS treatment of children with early can improve the oxygenation by increasing gas exchange area, but before FiO 2 to reduce the application of PS can cause local and/or systemic hemodynamic changes, making the use of PS has some potential problems, such as increasing the incidence of the IVH, PH, PDA and so on. SR rescue therapy can be divided into early treatment and delayed treatment, but the specific boundary point of the appropriate time period has not been clear. This paper aims to compare the efficacy differences of PS administration at different time periods and provide basis for the selection of clinical application period of PS. Methods: Case-control study . 135 children diagnosed with NRDS in neonatology department of our hospital. The patients were divided into two groups according to the use time of PS. Group A was applied within 3 hours after birth, and group B was applied 3 hours after birth. The changes of blood gas analysis parameter，mechanical ventilation time, incidence of complications, hospital stay and mortality were compared between the two groups. Results : The decrease of blood gas PaCO 2 in group A before and after treatment was more significant than that of group B (P<0.05), but the improvement of PaO 2 and OI in group B was better than that in group A (P<0.05). Although there were significant differences in birth weight between the two groups, there were no significant differences in the total duration of mechanical ventilation and mortality (P>0.05). Except PDA and BPD, there was no significant difference in the incidence of common complications between the two groups. Conclusion: PS treatment within 3 hours after birth can better improve ventilation, reduce the incidence of PDA. It can also help to reduce the death rate of high-risk children and the total duration of mechanical ventilation.

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Pengaruh Jenis Minyak Terhadap Sifat Fisik Sabun Mandi Cair

Jurnal Surya Medika ◽

10.33084/jsm.v6i1.1614 ◽

2020 ◽

Vol 6 (1) ◽

pp. 13-17

Author(s):

Febrina Nugrahini ◽

Nining Sugihartini ◽

Laela Hayu Nurani

Keyword(s):

Olive Oil ◽

Ph Value ◽

Coconut Oil ◽

Specific Weight ◽

Liquid Bath ◽

Plate Count ◽

Group A ◽

Oil Characteristics ◽

Group B

Soap is obtained from the saponification reaction that occurs between oil and alkaline solution. Various kinds of oils used in soap making also affect the quality of soap. The purpose of this study is to determine the effect of oil type on the physical properties of liquid bath soap. This research was divided into 3 groups, coconut oil group (A), VCO oil group (B), and olive oil group (C). Liquid bath soap obtained from each type of oil is tested based on SNI provisions including a soap quality test (oil characteristics test, organoleptic test, pH test, specific gravity, total plate count), viscosity test, and antioxidant test. Liquid bath soap of the three types of oil has the same shape, color, and odor. Coconut liquid soap, VCO, and olives respectively have a pH value of 6.64; 6.9; 6.52. (P = 0,000) Specific weight 1.0511; 1.0427; 1.0425. Viscosity 558cps; 686; 420. (p = 0.003) IC50 3547.36; 4523.46; 3542.02. (p = 0.035). Bath soaps that best meet SNI requirements are those made with olive oil.

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Experience of N-acetylcysteine airway management in the successful treatment of one case of critical condition with COVID-19

10.21203/rs.3.rs-34193/v1 ◽

2020 ◽

Author(s):

Yan Liu ◽

Guoshi Luo ◽

Xin Qian ◽

Chenglin Wu ◽

Yijun Tang ◽

...

Keyword(s):

Mechanical Ventilation ◽

Respiratory Failure ◽

Airway Management ◽

Critical Condition ◽

Respiratory Support ◽

Artificial Airway ◽

Anastomotic Fistula ◽

Management Experience ◽

Novel Coronavirus ◽

Acid Test

Abstract Object: To report the successful diagnosis and treatment of a patient with critical condition of novel coronavirus pneumonia (COVID-19) and to summarize its clinical features and airway management experience in successful treatment.Methods: Retrospectively analyzed the successful management of one case of COVID-19 with critical condition combined respiratory failure and discussed the clinical characteristics and airway management of the patient in conjunction with a review of the latest literature.Results: A patient with an anastomotic fistula after radical treatment of esophageal cancer and right-side encapsulated pyopneumothorax was admitted with cough and dyspnea and was diagnosed with novel coronavirus pneumonia and malnutrition by pharyngeal swab nucleic acid test in combination with chest CT. The patient was treated with antibiotics, antiviral and antibacterial medications, respiratory support, expectorant nebulization, and nutritional support, expressed progressive deterioration. Endotracheal intubation and mechanical ventilation were performed since the onset of the type Ⅱ respiratory failure on the 13th day of admission. The patient had persistent refractory hypercapnia after mechanical ventilation. Based on the treatment mentioned above, combined with repeated bronchoalveolar lavage by using N-acetylcysteine (NAC) inhalation solution, the patient's refractory hypercapnia was gradually improved. It was cured and discharged after being given the mechanical ventilation for 26 days as well as 46 days of hospitalization, currently is surviving well.Conclusion: Patients with severe conditions of novel coronavirus pneumonia often encounter bacterial infection in their later illness-stages. They may suffer respiratory failure and refractory hypercapnia that is difficult to improve due to excessive mucus secretion leading to small airway obstruction. In addition to the use of reasonable antibiotics and symptomatic respiratory support and other treatment, timely artificial airway and repeated bronchoalveolar NAC inhalation solution lavage, expectorant and other airway management are essential for such patients.

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