加热湿化器在气管切开患者氧疗中的效果观察

目的 观察加热湿化器在气管切开氧疗患者气道湿化中的应用效果.方法 将ICU 64例气管切开患者,随机分为两组,实验组采用加热湿化器给氧法患者32例,对照组采用湿化瓶鼻导管吸氧、微量泵泵入湿化液湿化法32例.观察两组患者气道湿化和氧疗效果.结果 加热湿化器给氧法患者湿化和氧疗效果明显优于湿化瓶鼻导管吸氧、微量泵泵人湿化液...     

颅脑损伤患者气管切开术后人工气道湿化方法比较与护理

目的探讨颅脑损伤重症监护病房（ICU）患者在建立人工气道后的护理方法,比较观察传统人工和微泵持续湿化气道的不同效果。方法选择已使用机械通气7d以上的患者20例,随机分为观察组和对照组,每组10例。观察组使用微泵持续滴注给药．并向套管内注入低渗盐水（0．45％氯化钠溶液）湿化气道：对照组采取人工间断推注生理盐水（0．9％氯化钠溶液）100mL加安溴索4mL,并在常温下定时、间断向套管内推注生理盐水,每次2～6mL湿化气道。对比观察10d后两组患者发生肺部感染、痰痂形成、刺激性咳嗽、气道出血等并发症情况。结果观察组各种并发症发生情况均低于对照组。结论微泵持续湿化气道的效果明显优于传统间断气管内湿化方法,而且无需采用生理盐水湿化．适用于建立人工气道后的ICU患者的气道湿化。     

气切式医用雾化器在气管切开患者中的应用

目的:探讨气切式医用雾化器在气管切开患者中的临床应用效果.方法:将我院气管切开患者60例随机分为观察组和对照组各30例,对照组给予人工鼻进行气道湿化,观察组给予气切式医用雾化器进行气道湿化,评估两组气道湿化效果.结果:观察组患者气道湿化满意率明显高于对照组,两组比较差异具有统计学意义(P＜0.05).观察组患者相关并发症发生率为3.33％,对照组为30.00％,两组比较差异具有统计学意义(P＜0.05).结论:气切式医用雾化器在气管切开患者中的临床效果好,并发症少,值得应用.     

提高无创呼吸机湿化效能的护理进展

综述了湿化装置、湿化液、湿化目标及效能对无创呼吸机病人的影响,为临床无创呼吸机采取针对性的湿化措施提供参考。     

人工鼻和输液泵持续湿化用于人工气道患者的效果

目的 了解人工气道湿化过程中,不同湿化方法的选择对湿化效果的影响.方法 选择2008年12月-2009年12月在我院应用人工鼻的人工气道患者52例,以方便抽样的方法分为实验组29例和对照组23例.实验组采用输液泵持续气道湿化,对照组采用注射器间歇滴注湿化,湿化液均采用0.45%氯化钠溶液125 mL+5%碳酸氢钠125 mL+氨溴索30 mg进行气道湿化.结果 实验组的湿化效果与对照组比较,差异有统计学意义(P<0.05);实验组的相关并发症与对照组比较,差异有统计学意义(P<0.05).结论 人工气道机械通气中采用输液泵持续气道湿化,具有操作简单、安全可靠、效果确切及并发症少等优点,明显优于传统的气道内定时、间断注入湿化液的方法.     

气管切开术后气道湿化对痰液成分改变的相关性研究

目的 从痰液成分的定量研究来探讨三组不同气道湿化法的利弊.方法 随机选取我院气管切开术后患者54例,作为痰液标本收集的对象.分别采用定时法、持续法及定时加雾化法后.测定痰液成分中α-酸性糖蛋皇、Ca2+含量和pH值.结果 定时加雾化组痰液成分中α-酸性糖蛋白、Ca2+含量低于定时组、持续组中的含量,三组些较差异有极显著...     

可调节精密输液器在气道湿化中的应用

目的观察可调节精密输液器在持续气道湿化中的应用效果。方法将80例开放气道患者随机分成观察组和对照组,观察组用可调节精密输液器持续气道滴入湿化,对照组用微量注射泵持续气道滴入湿化,观察两组患者的气道湿化效果及并发症。结果观察组和对照组,均能达到理想的湿化效果,差异无显著意义（P〉0.05）。结论使用可调节精密输液器持续气道湿化湿化效果好,具有操作简单,安全可靠,疗效确切,并发症少,经济等优点。     

综合护理措施在预防呼吸机相关性肺炎中的作用

目的比较改进的综合护理措施与传统的护理措施在预防呼吸机相关性肺炎中的效果。方法将64例于我院重症监护病房（ICU）接受机械通气治疗的患者随机分为试验组与对照组。在年龄、性别、APACHEII评分、VAP危险因素、基础疾病等方面无显著性差异。对照组进行传统护理干预,试验组进行综合护理干预。观察两组的痰细菌培养结果、VAP例数、VAP时间发生率、插管时间、ICU住院时间、ICU费用、死亡例数。结果试验组痰细菌株数、VAP例数、VAP时间发生率、插管时间、ICU住院时间、ICU费用、死亡例数明显少于对照组（P〈0．05）。结论综合护理措施可降低医院感染发生率、VAP发病率、死亡率,缩短住院时间,减轻机械通气患者医疗负担。     

High-flow via a tracheostomy tube and speaking valve during weaning from mechanical ventilation and tracheostomy

Background

Weaning from mechanical ventilation and tracheostomy after prolonged intensive care consume enormous resources with optimal management not currently well described. Restoration of respiratory flow via the upper airway is essential and early cuff-deflation using a one-way valve (OWV) is recommended. However, extended OWV use may cause dry airways and thickened secretions which challenge the weaning process. High-flow therapy via the tracheostomy tube (HFT-T) humidifies inspired air and may be connected via an in-line OWV (HFT-T-OWV) alleviating these problems. We aim to provide clinical and experimental data on the safety of HFT-T-OWV along with a practical guide to facilitate clinical use during weaning from mechanical ventilation and tracheostomy.

Methods

Data on adverse events of HFT-T-OWV were retrieved from a quality register for patients treated at an intensive care rehabilitation center between 2019 and 2022. Benchtop experiments were performed to measure maximum pressures and pressure support generated by HFT-T-OWV at 25–60 L/min flow using two different HFT-T adapters (interfaces). In simulated airway obstruction using a standard OWV (not in-line) maximum pressures were measured with oxygen delivered via the side port at 1–3 L/min.

Results

Of 128 tracheostomized patients who underwent weaning attempts, 124 were treated with HFT-T-OWV. The therapy was well tolerated, and no adverse events related to the practice were detected. The main reason for not using HFT-T-OWV was partial upper airway obstruction using a OWV. Benchtop experiments demonstrated HFT-T-OWV maximum pressures <4 cmH₂O and pressure support 0–0.6 cmH₂O. In contrast, 1–3 L/min supplemental oxygen via a standard OWV caused pressures between 84 and 148 cmH₂O during simulated airway obstruction.

Conclusions

Current study clinical data and benchtop experiments indicate that HFT-T-OWV was well tolerated and appeared safe. Pressure support was low, but humidification may enable extended use of a OWV without dry airway mucosa and thickened secretions. Results suggest the treatment could offer advantages to standard OWV use, with or without supplementary oxygen, as well as to HFT-T without a OWV, for weaning from mechanical ventilation and tracheostomy. However, for definitive treatment recommendations, randomized clinical trials are needed.     

盐酸氨溴索注射液间断气道湿化在长期机械通气患者的应用研究

目的探讨盐酸氨溴索注射液间断气道湿化在机械通气患者中的湿化效果。方法收集2010年6月～2012年10月在我院住院建立人工气道的患者40例，采用病例对照研究的方法，实验组和对照组分别采用盐酸氨溴索注射液和传统湿化液（2．5％碳酸氢钠溶液）进行气道湿化，并对两组湿化效果进行评价。结果痰液量均值实验组高于对照组，两组差异有显著意义（P〈0．05）。结论在间断气道湿化中，盐酸氨溴索注射液气道湿化效果优于传统湿化液。值得临床推广应用。