A clinical practice providing the more appropriate airway humidification methods applied on patients with severe traumatic brain injury

BACKGROUND: Practice guidelines (CPGs) provide informed treatment recommendations from systematic reviews and assessment of the benefits and harms that are intended to optimize patient care. Review of CPGs addressing rehabilitation for people with moderate/severe traumatic brain injury (TBI), has not been fully investigated. OBJECTIVE: Identify published, vetted, clinical practice guidelines that address rehabilitation for people with moderate/severe TBI. METHODS: Six data bases were accessed using key word search terms: “Traumatic Brain Injury” and “Clinical Practice Guidelines” and “Rehabilitation”. Further inclusions included “adult” and “moderate or severe”. Exclusions included: “mild” and “concussive injury”. Three reviewers read abstracts and manuscripts for final inclusion. The AGREE II template was applied for additional appraisal. RESULTS: There were 767 articles retrieved using the search terms, 520 were eliminated because of content irrelevance; and 157 did not specify rehabilitation treatment or did not follow a process for CPGs. A total of 17 CPGs met all criteria and only 4 of these met all AGREE II criteria. CONCLUSION: There are few CPGs addressing rehabilitation for people with moderate/severe TBI. More interventional trials are needed to determine treatment effectiveness. Timely and methodologically sound vetting of studies are needed to ensure CPG reliability and facilitate access to quality, effective treatment for people with moderate/severe TBI.

Download Full-text

A clinical practice evaluating the more appropriate airway humidification methods applied on patients with severe traumatic brain injury

10.21203/rs.3.rs-16815/v1 ◽

2020 ◽

Author(s):

xiaohong yin ◽

Banyou MA ◽

Lei YANG ◽

Hua SUN ◽

Zhilei YUN ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Severe Traumatic Brain Injury ◽

Secondary Infection ◽

Formation Rate ◽

Nursing Workload ◽

Airway Humidification ◽

Group A ◽

Group B ◽

Heat And Moisture

Abstract Airway humidification is an essential treatment for severe traumatic brain injury (STBI) patients after tracheotomy. To date, there was no relevant quantitative study evaluating these humidification ways and providing the appropriate method for the long-term nursing of these patients. In this study, 150 patients whom received tracheotomy treatment in our hospital from January 2016 to November 2018 were recruited into this study. Subjects were divided into three groups according to the humidification way that they received. The groups were oxygen spraying group (group A), Heat and moisture exchanger (HME) group (group B) and the heating and humidification group (group C). Phlegm viscosity, humidification effect, phlegm formation rate, daily sputum inhalation times, airway spasm, secondary lung infection, daily nursing times, nurses' internal satisfaction were evaluated. The C method is superior to both A and B methods in most aspects. A method trends to happening with insufficient or excessive humidification. Phlegm scab formation is significantly less in group C. The B and C methods had equal humidification effects and need similar daily sputum inhalation nursing. Airway spasm was frequent happened in group A than that in groups B and C. Secondary infection happened in all groups, the number of infected patients showed a decreasing trend and the infection degree showed no difference in the first 7 days between group C and group A. And the severity but not the infection ratio significantly decreased in Group C on the 30 th day. Method A significantly reduced nursing workload, but gained the worst humidification effects. Collectively, C method is more suitable for the airway nursing of patients with severe traumatic brain injury.

Download Full-text