Objective To study the clinical feasibility of invasive mechanical ventilation with bilevel positive airway pressure（BiPAP） non-invasive ventilator in the stable patients needing prolonged mechanical ventilation.Methods Eleven patients with respiratory failure admitted in intensive care unit（ICU）of our department，who needed prolonged mechanical ventilation，between Jun 2004 and Nov 2007 were enrolled in the study and followed until death or Jan 2008.The arterial blood gas analysis data，length of stay(LOS)，LOS after changing to BiPAP non-invasive ventilator（Synchrony，Harmony，RESPIRONICS，VPAP III ST-A，RESMED），survival time after discharge(or fulfilled the discharge standards) were reviewed retrospectively.Results The settings of inspiratory pressure，expiratory pressure and respiratory rate of non-invasive ventilation were 21.3 (16-26) cm H2O，4 cm H2O，and 16 min-1，respectively.The LOS (or up to the discharge standard) was (91.5±50.2) days.The LOS (or up to the discharge standard) after changing to BiPAP ventilator was (23.5±12.2) days.The mean survival time after discharge (or up to the discharge standard) was (353.1±296.5) days.Four patients were still alive up to the end of the study.The arterial pH，PaCO2，PaO2，and SaO2 were not significant different before and after changing to BiPAP ventilator.Conclusion The mechanical ventilation with BiPAP non-invasive ventilator via tracheotomy tube is an alternative choice for stable patients needing prolonged mechanical ventilation.
Objective To summarize the experience of providing medical supplies for the medical rescue after the Wenchuan earthquake so as to provide information for similar tasks in the future. Methods We collected and analyzed relevant data from the Medical Supply Group of the Headquarters for Earthquake Resistance and Disaster Relief. Results ① The Medical Supply Group of the Headquarters for Earthquake Resistance and Disaster Relief was set up immediately after the quake. Professional software for the medical supply information management was developed to ensure the completeness and timeliness of relevant data. ② Within the first 3 days after the quake, 12 460 medical device parts were delivered to the disaster area, which effectively ensured the availability of medical supplies for the “golden 72 hours”. ③ A great amount of donated material from other provinces and overseas also arrived. These donations reached a peak 2 weeks after the quake. A total of 428 411 drug products, 196 504 medical device parts and 5 999.4 tons of disinfection material were successfully delivered to most of the quake-stricken areas within 24 hours after its delivery to Sichuan province. ④ Three months after the quake, the remaining 193 831 drug products, 96 423 medical device parts and 2 000 tons of disinfection material were disposed appropriately. A regional medical supply warehouse was established to reserve 129 895 drug products, 74 018.4 medical device part and 231.28 tons of disinfection material. On the 115th day after the quake, a portion of these reserves were allocated to the quake-hit areas in Panzhihua, Liangshan, and Yunnan province. ⑤ Nearly 20 tons of drug products, 10 tons of medical devices and 724.54 tons of disinfection materials were properly destroyed due to expiration or disqualification. ⑥ Based on the data collected during the disaster relief work, a series of articles were published. Conclusion The medical supply work for the medical rescue after the Wenchuan earthquake was efficient, well-organized, transparent, and open.
Objective To report the anti-epidemic work for counterpart-supporting Longmen township, the epicenter of Lushan earthquake, by Mianyang health and epidemic prevention team from the first day to one month after the earthquake. Methods a) The following information was collected: work information and report forms of each counterpart-support small group, government work information, work information statistics and historical epidemic materials of health center, and epidemic prevention materials of Beichuan county. b) The epidemic prevention work of Longmen township from the first day to one month after earthquake were documentarily described, the expert group review was adopted to assess the disaster situation, epidemic situation and health needs, and the visual observation and trace method were used to monitor the vectors. Results a) The first team arrived in Ya’an city at the 19th hour after earthquake. The members of the team put forward the “City in-charge-of Township counterpart-support anti-epidemic mode” and they were approved to counterpart-support Longmen township. b) The second team involving 48 members assigned to the first team within 5 days after earthquake. Totally 224 local people were called up and they carried out a comprehensive work based on the “City in-charge-of Township counterpart-support anti-epidemic mode”: water quality and disease surveillance, disinfection and disinsectization at key sites, epidemic prevention in settlements, large-scale health education, and psychological intervention. c) As of 1 month after the earthquake, Mianyang health and epidemic prevention team had dispatched 20 vehicles and 122 people participated in the post-disaster epidemic prevention in Longmen township. The total disinfection area was 1 725 400 square meters, and disinsectization area was 1 162 500 square meters; 184 water samples were collected, and 7 717 family-times’ drinking water disinfection were guided; nearly 28 000 publicity materials were distributed; 8 636 people were visited and received for diagnosis; 33 cases with watery diarrhea and 16 cases with fever were found; 117 people were trained about mental health service, 3 mental health service stations were set up, and 1 152 people were helped with special population mental health services. Conclusion a) Mianyang health and epidemic prevention team combined the special requirements of epidemic prevention in Lushan earthquake with the proficient experiences and work modes of epidemic prevention in Mianyang as the extremely-severe stricken area in Wenchuan earthquake, and put forward the “City in-charge-of Township counterpart-support mode” which is implemented and verified in the anti-epidemic practice in epicenter of Longmen Township. b) Compared with the epidemic prevention in Qushan township of Beichuan county which is the epicenter of both Lushan and Wenchuan earthquakes: the following 8 aspects (including the “City in-charge-of Township counterpart-support” formed, the first anti-epidemic team entered into the village, full coverage of anti-epidemic team entered into the village, direct reporting network recovered, settlement’s regular administration started, water supply guaranteed, drinking water monitoring initiated, emergency vaccination initiated) were performed earlier in Lushan than Wenchuan, with 42 days, 2 days, 32 days, 4 days, 10 days, 6 days, 7 days, and 19 days in advance, respectively. c) The overall performance is faster, more reasonable, and more efficient. It can provide first-hand information for globally similar earthquake’s epidemic prevention, and also the decision-making and reference for both post-disaster reconstruction and construction of regional state disaster emergency response system.