Application of Standardized Nursing Procedures Combined with Specialized Management Education in Extracorporeal Membrane Oxygenation in ICU

2021 ◽  
Vol 7 (4) ◽  
pp. 647-654
Author(s):  
Min Zhang ◽  
Lingling Wu ◽  
Weihong Shen ◽  
Ying Shen
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Completion Time ◽  
Management Education ◽  
Control Group ◽  
Average Weight ◽  
Efficacy Rate ◽  
Observation Group ◽  
Nursing Management ◽  
Preparation Time ◽  
Membrane Oxygenation

To analyze the application effect of standardized nursing procedures combined with specialized management education in extracorporeal membrane oxygenation (ECMO) in ICU. 18 patients treated with ECMO in our department from July 1, 2020 to December 30, 2020 were chosen as observation group, and 18 patients receiving ECMO in our department (January 2017-June 2018) were selected as control group. The control group received routine procedures in the implementation of ECMO nursing while the observation group received standardized ECMO nursing procedures combined with specialized management education to analyze the effect of different nursing management methods on ECMO patients by comparing the indexes before and after nursing management. There were no obvious differences in gender ratio, average age, average weight, average BMI, marital status, education and residence between the two groups (P > 0.05). Personnel arrival time, start time of rescue, preparation time of items, pipeline prefilling time and catheter completion time in observation group were obviously better compared with control group (P < 0.001). The total clinical efficacy rate in observation group was obviously higher compared with control group (P < 0.05). There were no significant differences in the Pa02, SP02 and PaC02 levels between the two groups before nursing management (P > 0.05), and the levels in observation group were obviously higher compared with control group after nursing management (P < 0.001). The clinical nursing satisfaction in observation group was obviously higher compared with control group (P < 0.05). The sequential organ failure assessment (SOFA) score in observation group after nursing management was obviously lower compared with control group (P < 0.001). The incidence of complications in observation group was obviously lower compared with control group (P < 0.05). The implementation of standardized nursing procedures combined with specialized management education for ECMO patients can effectively shorten rescue time, the preparation time before catheterization and catheter completion time, improve the therapeutic effect, and improve blood gas indicators, safe and effective. At the same time, it can facilitate the doctor-nurse cooperation, worthy of promotion and application.

Extracorporeal Membrane Oxygenation: Current Use and Future Directions

1990 ◽  
Vol 1 (2) ◽  
pp. 348-364 ◽  
Author(s):  
Beth Kaplan McDermott ◽  
Martha A. Q. Curley
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Pediatric Population ◽  
Critical Care Nursing ◽  
Nursing Management ◽  
Ecmo Patient ◽  
Future Directions ◽  
Membrane Oxygenation ◽  
Critically Ill Neonates ◽  
Cardiac System

Extracorporeal membrane oxygenation (ECMO) is the process of using prolonged cardiopulmonary bypass to support patients with reversible respiratory and/or cardiac failure who are refractory to maximal conventional therapy. This process has been used extensively for critically ill neonates, with encouraging results. The use of ECMO in the pediatric population has been limited but is increasing. The history, mechanics, and current applications of ECMO are discussed in this article. Critical care nursing management of the pediatric or neonatal ECMO patient focuses on optimizing recovery of the pulmonary and/or cardiac system while preventing complications. A case study of a pediatric ECMO patient is presented which illustrates the complex nursing care issues related to use of this intervention. Future directions for ECMO are addressed

scholarly journals Lessons learned from extracorporeal membrane oxygenation as a bridge to lung transplantation

2014 ◽  
Author(s):  
Vladimir Shumaster ◽  
Oliver Jawitz ◽  
David Yuh ◽  
Pramod Bonde
Keyword(s):  
Postoperative Complications ◽  
Extracorporeal Membrane Oxygenation ◽  
Lung Transplantation ◽  
Survival Rates ◽  
Length Of Hospital Stay ◽  
Lessons Learned ◽  
Control Group ◽  
Membrane Oxygenation ◽  
Lung Transplants ◽  
United Network

Extracorporeal membrane oxygenation (ECMO) has been used infrequently as a bridge to lung transplantation due to lack of consensus and data regarding the benefits of such a strategy. We present data from the United Network of Organ Sharing (UNOS) database on the outcomes of patients bridged to lung transplantation with ECMO. We used the UNOS database to analyze data between January 1, 2000 and December 31, 2011. During this time 14,263 lung transplants were performed, of which 143 (1.0%) were bridged using ECMO. Patients on ECMO as a bridge to lung transplantation were compared to those transplanted without prior ECMO support. Demographics, survival rates, complications, and rejection episodes were compared between the two groups. The 30-day, 6-month, 1-year, 3-year, and 5-year survival rates were 69%, 56%, 48%, 26%, and 11%, respectively, for the ECMO bridge group and 95%, 88%, 81%, 58%, and 38% respectively, for the control group (p ≤ 0.01). The ECMO group incurred higher rate of postoperative complications, including airway dehiscence (4% vs. 1%, p ≤ 0.01), stroke (3% vs. 2%, p ≤ 0.01), infection (56% vs. 42%, p ≤ 0.01), and pulmonary embolism (10% vs. 0.6%, p ≤ 0.01). The length of hospital stay was longer for the ECMO group (41 vs. 25 days, p ≤ 0.01), and they were treated for rejection more often (49% vs. 36%, p = 0.02). The use of ECMO as a bridge to lung transplantation is associated with significantly worse survival and more frequent postoperative complications. Therefore, we advocate very careful patient selection and cautious use of ECMO.

scholarly journals Nursing Management of Severe COVID-19 Patients Undergoing Extracorporeal Membrane Oxygenation Combined with Prone Position Ventilation

2020 ◽  
Vol 23 (4) ◽  
pp. E422-E425
Author(s):  
Qing Nie ◽  
Aiwu Ye ◽  
Shixiong WeiW
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Lung Injury ◽  
Extracorporeal Membrane Oxygenation ◽  
Respiratory Distress Syndrome ◽  
Prone Position ◽  
Distress Syndrome ◽  
Nursing Management ◽  
Membrane Oxygenation ◽  
Oxygenation Level ◽  
Ecmo Treatment

Acute respiratory distress syndrome (ARDS) is a serious lung injury in patients with severe coronavirus disease 2019 (COVID-19). This process often is difficult to reverse, eventually leading to the death of patients. Extracorporeal membrane oxygenation (ECMO) treatment can provide patients with cardiopulmonary function support and buy time for clinicians' treatment. However, some patients still suffer from poor oxygenation after ECMO treatment. At this time, nurses can change the patient's position to prone position to improve oxygenation level and promote sputum excretion. It is a great challenge for COVID-19 patients to change their postures while receiving ECMO treatment. This article provides suggestions for this process by reviewing our hospital's experience in treating severe COVID-19 patients.

Lipid peroxidation during initiation of extracorporeal membrane oxygenation after hypoxia in endotoxemic rabbits

Perfusion ◽  
1999 ◽  
Vol 14 (1) ◽  
pp. 49-57 ◽  
Author(s):  
Gerhard Trittenwein ◽  
Alexandre T Rotta ◽  
Björn Gunnarsson ◽  
David M Steinhorn
Keyword(s):  
Lipid Peroxidation ◽  
Oxidative Damage ◽  
Extracorporeal Membrane Oxygenation ◽  
Pulmonary Function ◽  
G Protein ◽  
Lung Tissue ◽  
Control Group ◽  
Factors Affecting ◽  
Membrane Oxygenation ◽  
Venovenous Ecmo

Initiation of extracorporeal membrane oxygenation (ECMO) in septic children with severe respiratory failure often improves oxygenation but not pulmonary function. The factors affecting pulmonary function following onset of ECMO are not completely understood, but are thought to involve injury mediated, in part, by reactive oxygen species. We hypothesized that induction of ECMO using 100% oxygen as the sweep gas through the oxygenator would increase lipid peroxidation in endotoxin-primed animals after severe hypoxia. We further speculated that provision of oxygenated blood to the pulmonary circulation via venovenous ECMO would promote a greater degree of oxidative damage to the lung as compared to venoarterial ECMO. Eighteen New Zealand White rabbits were assigned to a control group (control) or two intervention groups subjected to 60 min of venoarterial or venovenous ECMO. ECMO was initiated following an intravenous challenge with 0.5 mg/kg of E. coli endotoxin and a period of global hypoxia leading to an arterial pH of 6.99 ± 0.09, PaCO2 of 103 ± 31 mmHg and PaO2 of 27 ± 5 mmHg. Malondialdehyde (MDA), a marker of lipid peroxidation, was measured in lung tissue homogenates and in arterial plasma. Lung tissue MDA demonstrated a strong trend towards an increase in the venoarterial group (1884 ± 945 nmol/g protein) and in the venovenous group (1905 ± 758 nmol/g protein) in comparison to the control group (644 ± 71 nmol/g protein) ( p = 0.1; significance at 95% in Scheffe test). Lung tissue MDA in the venovenous group had a significant correlation with mean PaO2 during ECMO by regression analysis ( r2 = 0.678, p = 0.044). The change in blood MDA concentration between pre-ECMO and post-ECMO values was greater in the venovenous group (pre 1.62 ± 0.61 versus post 5.12 ± 0.2.07 μmol/l, p = 0.043) compared with that seen in the venoarterial group (pre 1.46 ± 0.38 versus post 3.9 ± 0.93 μmol/l). Our data support the hypothesis that initiation of ECMO with a circuit gas oxygen concentration of 100% after global hypoxia enhances oxidative damage to lipids in endotoxin-challenged animals. During venovenous ECMO this finding is dependent on PaO2.

scholarly journals Resection of extrahepatic bile ducts with partial hepatectomy for treating intra- and extrahepatic hepatolithiasis

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
HongTian Xia ◽  
XiangFei Meng ◽  
XianLei Xin ◽  
Tao Yang ◽  
Yang Liu ◽  
...  
Keyword(s):  
Bile Duct ◽  
Surgical Procedures ◽  
Bile Ducts ◽  
Control Group ◽  
Efficacy Rate ◽  
Observation Group ◽  
Surgical Methods ◽  
Cox Analysis ◽  
Fair Poor

Abstract Background To evaluate the efficacy and safety of our new surgical procedures for primary intra- and extrahepatic hepatolithiasis. Hepatolithiasis is an intractable disease with frequent recurrences. Methods From 1996 to 2005, 142 patients with intrahepatic and/or extrahepatic hepatolithiasis treated with the conventional surgical methods were included as the control group, while 128 consecutive patients treated with new surgical methods from 2006 to 2015 were included as the observation group. The new surgical procedures included a comprehensive intraoperative exploration of the bile ducts, focusing on the structure and function of the hilar bile duct and duodenal papilla, exploration of the affected liver, and bile culture. Results The observation group had a significantly higher complete stone clearance rate than the control group (100% vs. 65.96%). The observation group had significantly lower incidences of cholangitis and bile duct stones, as well as a higher excellent and good long-term surgical efficacy rate (86.24% vs. 52.73%). Multivariate Cox analysis showed that the control group had a higher risk for fair + poor efficacy than the observation group (HR: 8.47). Conclusions Our new surgical procedures are safe and can provide a good long-term efficacy for treating primary hepatolithiasis intra- and extrahepatic hepatolithiasis.

scholarly journals Effect Analysis of Hospital Nursing Management Based on Informatization

2021 ◽  
Vol 5 (5) ◽  
pp. 125-129
Author(s):  
Lijuan Zhang ◽  
Ling Sun ◽  
Huifang Cao ◽  
Shaofeng Zhu
Keyword(s):  
Information Management ◽  
Management System ◽  
Information Management System ◽  
Management Mode ◽  
Control Group ◽  
Observation Group ◽  
Nursing Management ◽  
Nursing Satisfaction ◽  
Hospital Nursing ◽  
Nursing Ward

Objective: To explore the effect of hospital nursing management based on informatization. Methods: 167 inpatients from different departments in our hospital from June 2020 to November 2019 were randomly selected and divided into control group and observation group.83 cases in the control group were treated with traditional nursing management mode; 87 cases in the observation group used modern nursing information management system for information-based nursing management, and then compared the two groups in terms of nursing management efficiency, patient basic nursing, ward management, specialized nursing and nursing satisfaction, so as to verify the clinical application effect of information-based nursing management. Results: After the application of information-based nursing management mode, the construction and application of information management system made the nursing management process more standardized and accurate. Therefore, the clinical nursing efficiency, basic nursing, ward management, specialized nursing and nursing satisfaction of the observation group were better than those of the control group. Conclusion: In the practice of hospital inpatient nursing management, the scientific use of information technology and information management system can significantly improve the efficiency of patient nursing management and nursing satisfaction, and play a key role in improving the prognosis of patients. Therefore, it is worth popularizing and applying in the whole hospital and even the national grass-roots hospitals.

scholarly journals Can Cardiopulmonary Rehabilitation Facilitate Weaning of Extracorporeal Membrane Oxygenation (CaRe-ECMO)? Study Protocol for a Prospective Multidisciplinary Randomized Controlled Trial

2022 ◽  
Vol 8 ◽  
Author(s):  
Yu Zheng ◽  
Hao Sun ◽  
Yong Mei ◽  
Yongxia Gao ◽  
Jinru Lv ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Mechanical Ventilation ◽  
Critical Illness ◽  
Extracorporeal Membrane Oxygenation ◽  
Usual Care ◽  
Control Group ◽  
Randomized Controlled ◽  
Membrane Oxygenation ◽  
Secondary Outcomes ◽  
Ecmo Therapy

Background: Mortality of patients suffering from critical illness has been dramatically improved with advanced technological development of extracorporeal membrane oxygenation (ECMO) therapy. However, the majority of ECMO-supported patients failed to wean from ECMO therapy. As one of several options, cardiopulmonary rehabilitation serves as effective intervention in the improvement of cardiovascular and respiratory function in various major critical illness. Nonetheless, its role in facilitating ECMO weaning has not yet been explored. The purpose of this study is to investigate the effectiveness of cardiopulmonary rehabilitation on rate of ready for ECMO weaning in ECMO-supported patients (CaRe-ECMO).Methods: The CaRe-ECMO trial is a randomized controlled, parallel group, clinical trial. This trial will be performed in a minimum number of 366 ECMO-supported eligible patients. Patients will be randomly assigned to either: (1) the CaRe-ECMO group, which will be treated with usual care including pharmacotherapy, non-pharmacotherapy, and specific nursing for ECMO therapy and the CaRe-ECMO program; or (2) the control group, which will receive usual care only. The CaRe-ECMO program consists of protocolized positioning, passive range of motion (PROM) training, neuromuscular electrical stimulation (NMES), surface electrical phrenic nerve stimulation (SEPNS), and pulmonary rehabilitation. The primary outcome of the CaRe-ECMO trial is the rate of ready for ECMO weaning at CaRe-ECMO day 7 (refers to 7 days after the CaRe-ECMO program initiation). Secondary outcomes include rate of ECMO and mechanical ventilation weaning, total length in day of ready for ECMO weaning, ECMO weaning and mechanical ventilation, all-cause mortality, rate of major post-ECMO complications, ECMO unit length of stay (LOS) and hospital LOS, total cost for hospitalization, cerebral performance category (CPC), activities of daily living (ADL), and health-related quality of life (HRQoL).Discussion: The CaRe-ECMO is designed to answer the question “whether cardiopulmonary rehabilitation can facilitate weaning of ECMO (CaRe-ECMO).” Should the implementation of the CaRe-ECMO program result in superior primary and secondary outcomes as compared to the controls, specifically the add-on effects of cardiopulmonary rehabilitation to the routine ECMO practice for facilitating successful weaning, the CaRe-ECMO trial will offer an innovative treatment option for ECMO-supported patients and meaningfully impact on the standard care in ECMO therapy.Clinical Trial Registration:ClinicalTrials.gov, identifier: NCT05035797.

Magnetic Resonance Imaging and Health Analysis Applied to Nursing Strategies for Clinical Management

2020 ◽  
Vol 10 (6) ◽  
pp. 1315-1320
Author(s):  
Songmei Li ◽  
Xinbing Hao ◽  
Qi Wang
Keyword(s):  
Health Informatics ◽  
Process Reengineering ◽  
Control Group ◽  
Imaging Features ◽  
Observation Group ◽  
Nursing Management ◽  
Nursing Satisfaction ◽  
Hospital Patients ◽  
Nursing Errors ◽  
Nursing Quality

Objective: To explore the medical imaging features of lung cancer brain metastases, and to explore the application effect of health informatics process reengineering on nursing management. Methods: Retrospective analysis of the medical data of patients admitted, including the number of cases of nosocomial infections in the two years, and analysis and summary of the reasons for the hospital patients were divided into the control group and the observation group. The control group was treated with traditional care, and the observation group was re-engineered in the basic upward process of the control group. The nursing quality scores, the occurrence of nursing errors and the satisfaction of nursing were compared between the two groups. Results: The nursing quality score of the observation group was better than that of the control group. The incidence of nursing errors was lower than that of the control group. The patient’s nursing satisfaction was higher than that of the control group (P > 0.05). Conclusion: The implementation of process reengineering in nursing management can effectively improve the quality of indoor nursing work, reduce the incidence of error events in the nursing work process, and improve the satisfaction of patients and their families.

scholarly journals Budesonide/Fomoterol in combination with Montelukast in the treatment of Bronchial Asthma

2020 ◽  
Vol 36 (7) ◽  
Author(s):  
Xiaoxia Dai ◽  
Tao Feng ◽  
Xuejuan Zhang ◽  
Kaishu Li
Keyword(s):  
Symptom Score ◽  
Bronchial Asthma ◽  
Persistent Asthma ◽  
Inflammatory Factors ◽  
Control Group ◽  
Efficacy Rate ◽  
Observation Group ◽  
Creative Commons ◽  
The Difference ◽  
Open Access Article

Objective: To analyze the clinical effect of budesonide/fomoterol combined with montelukast in the treatment of chronic persistent asthma. Methods: Ninety-four patients with asthma who came to our hospital for treatment from April 2017 to April 2019 were randomly divided into control group and observation group, with 47 patients in each group. The control group was treated with budesonide/formoterol, and the observation group was treated with montelukast on the basis of the control group. The treatment effect of the two groups was observed and compared. Results: The total efficacy rate of the observation group was significantly higher than that of the control group (P<0.05); the daytime symptom score and nighttime symptom score of the observation group were significantly higher than those of the control group (P<0.05). The pulmonary function indexes of the two groups after treatment were significantly higher than that before treatment, and the improvement of the observation group was more significant (P<0.05); the FeNO and EO levels of the observation group after treatment were superior to those of the control group, and the difference was statistically significant (P<0.05). Conclusion: Budesonide/formoterol powder inhalation combined with montelukast can effectively improve the lung function, reduce the level of inflammatory factors, and accelerate the regression of symptoms in the treatment of chronic persistent asthma. It is worth clinical application. doi: https://doi.org/10.12669/pjms.36.7.2018 How to cite this:Dai X, Feng T, Zhang X, Li K. Budesonide/Fomoterol in combination with Montelukast in the treatment of Bronchial Asthma. Pak J Med Sci. 2020;36(7):---------. doi: https://doi.org/10.12669/pjms.36.7.2018 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Application of Seamless Nursing Management in Emergency-ICU Patient Safety Transfer and Handover

2019 ◽  
Vol 2 (2) ◽  
pp. 25
Author(s):  
Qian Wang ◽  
Lili Wei
Keyword(s):  
Emergency Department ◽  
Patient Safety ◽  
Nursing Staff ◽  
Satisfaction Score ◽  
Control Group ◽  
Observation Group ◽  
Nursing Management ◽  
Icu Patients ◽  
Overall Efficiency ◽  
Better Than

Objective: To analyze the application effect of seamless nursing management in the safe transfer and handover of emergency-ICU patients. Methods: A total of 160 patients admitted to the emergency department-ICU from November 2017 to July 2018 were randomly divided into the control group and the observation group, with 80 patients in each group. Among them, the patients in the control group underwent routine nursing management mode, and the patients in the observation group were treated with seamless nursing, comparing the transfer of the two groups of patients and the satisfaction score of the emergency-ICU nursing staff. Results: The transfer status of the observation group and the satisfaction score of the emergency-ICU nursing staff were significantly better than those of the control group. Conclusion: Seamless nursing management can improve the overall efficiency of transfer.

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