ObjectiveTo observe the effect of different preoxygenation methods for emergency intubation in severe patients in intensive care unit (ICU). MethodsProspective randomized study was performed in the intensive care unit between June 2013 and January 2014. Forty patients were randomly divided into 4 groups:group A (control group, n=10), group B (bag-valve-mask preoxygenation group, n=10), group C (noninvasive ventilator-mask preoxygenation group, n=10), and group D (invasive ventilator-mask preoxygenation group, n=10). Standardized rapid sequence intubation was performed without preoxygenation in group A; preoxygenation was performed by using a bag-valve-mask rose pulse oxygen saturation (SpO2) to 90% before a rapid sequence intubation in group B; preoxygenation was performed by using noninvasive ventilator through a face mask rose SpO2 to 90% before a rapid sequence intubation in group C; and preoxygenation was performed by using invasive ventilator through a face mask rose SpO2 to 90% before a rapid sequence intubation in group D. We recorded the time when SpO2 was more than or equal to 90% in group B, C, and D, and arterial blood gases and complications were observed. ResultsThere was no significant difference in the basic indexes before preoxygenation among the four groups (P>0.05). The time of the patients in group D and C was significantly lower than that of group B. The arterial oxygen saturation (SaO2) and arterial oxygen partial pressure (PaO2) in the group C and D were higher than those in group B after preoxygenation (P<0.05). After intubation, SpO2 in group B, C and D was significantly higher than that in group A (P<0.05). At the same time, SpO2 in group C and D was higher than that in group B (P<0.05); PaO2 and SaO2 in group C and D were higher than in those in group A and B (P<0.05); SaO2 in group D was higher than that in group B (P<0.05). The incidence of abdominal distension in group D was significantly lower than that of group B and C (P<0.05). ConclusionFor emergency tracheal intubation in critically ill patients in the ICU, preoxygenation is more effective than the rapid sequence intubation without preoxygenation in improving oxygenation indicators. Invasive ventilator-mask preoxygenation efficacy and safety are superior to other methods.
Objective To evaluate the advantages of perioperative painless indwelling urethral catheters in lobectomy of lung cancer. Methods We recruited 133 patients who were scheduled for lung cancer lobectomy under general anesthesia in Department of Thoracic Surgery in West China Hospital from April through December 2014. These patients were divided into two groups including a control group (68 patients) and a trial group (65 patients). The trial group was painless indwelled urethral catheter, and the control group was indwelled urethral catheter routinely. The clinical effectiveness between the two groups was compared. Results The rates of emergence agitation (EA) occurrence and urinary tract infection in the trial group (10.77%, 9.23%) were reduced than those in the control group (26.47%, 26.47%) with statistical differences (P=0.022, P=0.047). And the rate of comfort level (0 degree) of the patients in the trial group (87.69%) was significantly increased than that in the control group (48.53%, P=0.001). And postoperative hospitalization duration in the trial group (5.00±1.60 d) was shorter than that in the control group (6.48±3.14 d, P=0.004). Conclusion Perioperative painless indwelling urethral catheters in lobectomy of lung cancer has benefit of improving the comfort level of the patients and promoting fast-track rehabilitation in the patients with lung cancer.