Objective To compare the effects of high frequency oscillatory ventilation (HFOV) and conventional mechanical ventilation (CMV) whith or without pulmonary surfactant(PS) supplement on water vapour inhalation injury.Methods New Zealand rabbits model of severe acute lung injury with acute respiratory failure caused by steam inhalation was established.Then the animals were treated by CMV，HFOV，CMV+PS or HFOV+PS，respectively while animals in control group did not ventilated and supplemented with PS.Femoral arterial blood samples were obtained at 1，2，3，4 h after treatment for blood gas analysis.4 h after treatment ,the lowest lobe of right lung was weighed for calculating wet-to-dry weight ratio (W/D).Four different parts including dependent areas and non-dependent areas of the middle lobe of right lung were excised for histological observation.Results (A) After ALI established PaO2 in the five groups decreased below 60mmHg (Plt;0.01) but intergroup differences were found.Meanwhile the change of PaCO2 showd no statistical significance(Pgt;0.05).(B) PaO2 in the four treatment groups had increased since one hour after treatmentand sustained at favorite levels during treatment period.PaO2 in the HFOV and HFOV+PS groups were higher than those in CMV and CMV+PS groups,respectively (Plt;0.01，Plt;0.05).PaO2 in the CMV+PS group at 2 h and HFOV+PS group at 2 h and 3 h were significantly higher than those in corresponding non-PS groups at the same timepoints (Plt;0.05).P（A-a）O2 in the HFOV and HFOV+PS groups were lower than those in CMV and CMV+PS groups (Plt;0.05).P（A-a）O2 in the two groups with PS at 2 h，3 h and 4 h t were statistically lower than those in the two corresponding groups without PS (Plt;0.05).The pH and PaCO2 as well as circulatory function in the four groups were not significantly different at different treatment timepoints (Pgt;0.05).(C) Lung W/D was not different between CMV and HFOV groups (Pgt;0.05)，or CMV+PS and HFOV+PS.But lung W/D in the two groups treated with PS showed statistically decrement than that in non-PS groups (Plt;0.05).(D) Histological injury score was lowest in HFOV+PS group and highest in CMV group.Conclusion HFOV combined with exogenous PS supplement can improve arterial oxygenation and alleviate pulmonary edema and injury，which may be a optimal method for the treatment of acute lung injury with acute respiratory failure caused by water vapour inhalation.
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.
Objective To explore the application effect of recumbent rehabilitation exercise combined with oscillatory positive expiratory pressure training in pulmonary rehabilitation of patients with moderate to severe inhalation injury. Methods Fifty-seven patients with moderate-to-severe inhalation injuries admitted to the Department of Burns and Plastic Surgery of the People’s Hospital of North Jiangsu Province from January 2021 to March 2023 were selected by convenience sampling. The patients were randomly divided into Group A, Group B, and Group C. Group A received conventional treatment, Group B received the recumbent rehabilitation exercise on the basis of Group A, and Group C received the concussive expiratory pressure training on the basis of Group B. The three groups were compared before and after the intervention with respect to forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), sputum properties, sputum difficulty, sputum viscosity, average daily sputum output, Borg shortness of breath score, and 1-minute sitting and standing test. Results The improvement values of FEV1, FVC, sputum viscosity, average daily sputum discharge, Borg shortness of breath score, and 1-minute sit-to-stand test were compared among the three groups after intervention, and the differences were statistically significant (all P<0.05). The improvement values of Borg shortness of breath score, and 1-minute sit-to-stand test in group B were significantly better than those in group A (all P<0.05). The improvement values of FEV1, FVC, and sputum properties in group C were significantly better than those in group A (all P<0.05), Coughing difficulty, sputum viscosity, total average daily sputum expectoration, Borg shortness of breath score, and 1-minute sit-to-stand test improvement values were significantly better than those of group A (all P<0.05). Improvement values of FEV1, average daily sputum expectoration, and Borg shortness of breath score in group C were significantly better than those of group B (all P<0.05). Conclusion For pulmonary rehabilitation of patients with moderate-to-severe inhalation injuries, prone rehabilitation exercises combined with oscillatory positive expiratory pressure training can effectively improved the patients’ exercise capacity and respiratory function, and improve their quality of life.