Objective To investigate the safety and effectiveness of a self-made bronchoscopic catheter ( an improved artificial airway) in bronchoscopic interventional therapy.Methods 126 patients planning to receive bronchoscope between October 2012 and February 2013 were divided into A, B and C groups. Three groups received inhalation of 2% lidocaine 5mL for surface anesthesia, and the venous channel was build up. Then the patients in group A ( n = 45) were treated with conventional bronchoscope. The patients in group B ( n =40) were treated with painless bronchoscope ( received intravenous injection with midazolam0. 06 mg/kg and fentanyl 1μg/kg before operation) . The patients in group C ( n = 41) were treated with painless bronchoscope through improved artificial airway ( after anesthesia similar to group B, the improved artificial airway was implanted through the mouth guided by bronchoscope, then the bronchoscopy was performed through artificial airway) . Blood pressure, respiration rate, heart rate and the pulse oxygen saturation were measured by multi-parameter ECG monitor before and during the operation, and the differences were compared among three groups. Body movement, transient respiratory depression during the operation, and postoperative feelings and reactions after operation were also observed. Meanwhile, the convenience of operation by physicians was evaluated. Results The blood pressure fluctuations in group C and group A had no significant difference ( P gt;0. 05) . Heart rate of three groups was somewhat increased,but there was no significant difference between group C and group A ( P gt; 0. 05) . Body movement and postoperative pain memory in group B and group C were better than those in group A ( P lt; 0. 05) .Respiratory depression of three groups had no significant difference ( P gt; 0. 05) . The operative convenience and the comfort of physicians in group C were better than those in group A and group B ( P lt; 0. 05) .Conclusions Operation safety of bronchoscopic interventional treatment with improved artificial airway is similar to the conventional procedure, but the reaction of the intra-operation and postoperative painful memories are significantly superior to conventional bronchoscopy. The convenience of operation and comfort of physicians are much better than the conventional bronchoscopy. It can be concluded that the improved artificial airways is worthy of clinical application.
ObjectiveTo analyze the content of international clinical practice guidelines related to endotracheal suctioning of adults with an artificial airway, and to provide reference for developing corresponding domestic clinical practice guidelines. MethodsContent analysis method was used to analyze clinical practice guidelines searched from the Internet between January 2000 and December 2012. ResultsThree clinical practice guidelines were included and 21 items related to endotracheal suctioning of adults with an artificial airway were identified. ConclusionAlthough the existing clinical practice guidelines can help to guide endotracheal suctioning of adults with an artificial airway, there are some differences between guidelines and domestic operation standards. Researchers and clinical nurses should develop local clinical practice guidelines on endotracheal suctioning of adults with an artificial airway with consideration of the actual medical situations in China and the best evidences.
ObjectiveTo summarize the experiences of artificial airway management for inhalation injury patients undergoing tracheotomy. MethodsA retrospective analysis was made on the clinical data of 16 patients with inhalation injury who accepted artificial airway implantation after tracheotomy from January 2012 to October 2014. Certain measures were taken for the patients such as timely sputum suction in a correct way, effective airway moist, timely airway lavage, strict aseptic operation, reasonable position management, dynamic observation and health education. ResultsFifteen patients were cured, and one died. Among the cured patients, there were one case of catheter change due to blocked sputum, and one case of catheter outward portion sliding depth adjusting. ConclusionStrengthening artificial airway management after tracheotomy is the key to keep airway unobstructed, to prevent complications, and to guarantee the safety and a speedy recovery of patients.
ObjectiveTo compare the effects of different airway humidification methods for patients with artificial airway offline. MethodsOne hundred and fifty-five critically ill patients with artificial airway who did not need mechanical ventilation for more than 72 h, admitted in the Affiliated Hospital to Armed Police Logistics College between January 2012 and December 2012, were recruited in the study.They were randomly divided into 3 groups to receive different airway humidification treatment, ie.MR410 device for group A, MR850 device for group B, AIRVO2 device for group C.PaO2, SpO2, heart rate, and breathing frequency were measured after 72 h.The Airway Scoring System was used for evaluation of sputum viscosity.The time of pulmonary infection control was also recorded. ResultsThere were no significant differences in gender, age, underlying diseases, duration of artificial airway, and APACHEⅡscore among three groups (P > 0.05).There were significant differences in respiratory frequency, PaO2, SpO2, heart rate, sputum viscosity, humidification effect, lung infection control time among three groups (P < 0.05), with group C better than group A and B in above parameters. ConclusionsCompared with MR410 and MR850 humidification devices, AIRVO2 is a more ideal device for airway humidification, and is more suitable for patients with artificial airway offline.