输内管袖口修改在预防呼吸机相关肺炎方面的有效性
Yanshuo Wu1, Congcong Zhao1, Meirong Sun1
1Department of Critical Care Medicine, The Fourth Hospital of Hebei Medical University, Hebei, China.
Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
|September 11, 2023
概括
与传统袖子相比,修改后的内肌袖子显著降低了与呼吸机相关的肺炎 (VAP) 的发生率. 结合改进的袖口和下分泌液排水,在重症监护室提供了进一步的VAP预防优势.
科学领域:
- 临界护理医学 临界护理医学
- 预防传染病 预防传染病
- 医疗设备创新 医疗设备创新
背景情况:
- 呼吸机相关性肺炎 (VAP) 是机械呼吸患者的一种严重并发症.
- 传统的内管袖子可能允许微吸气,有助于VAP.
- 新型袖口设计旨在改善气道密封,降低VAP风险.
研究的目的:
- 评估修改后的内管袖口在预防VAP方面的有效性.
- 为了比较修改和传统袖口之间的VAP发病率和重症监护室 (ICU) 死亡率.
- 评估特定的修改型袖口类型和辅助疗法,如下分泌液排水 (SSD) 的影响.
主要方法:
- 随机对照试验 (RCT) 的系统审查和元分析.
- 在PubMed,Embase和Cochrane图书馆搜索到2022年4月.
- 包括9个RCT,涉及1937名机械呼吸患者.
主要成果:
- 修改后的手显著降低了VAP发生率 (RR=0.73,p=0.02).
- 特定的设计 (聚氨,形,PU-形) 没有单独显示显著的VAP减少.
- 改进的袖口与SSD的组合显著降低了VAP发生率 (RR=0.58,p=0.0001).
- 没有观察到ICU死亡率的显著差异 (RR=0.83,p=0.08).
结论:
- 修改后的内肌手套优于传统的手套,用于预防VAP.
- 修改版袖口和SSD的组合提供了对VAP的增强保护.
- 进一步的研究可能会探索最佳的袖口设计和用于减少VAP的辅助策略.
相关概念视频
Endotracheal Intubation I: Procedure
1.6K
Endotracheal or ET intubation is a critical medical procedure used to secure a patient's airway, often in acute respiratory distress, apnea, upper airway obstruction, ineffective clearance of secretions, high risk for aspiration, or during general anesthesia.
The ET tube comprises various components, including a standard adaptor to attach a bag-valve-mask (BVM) or ventilator, a cuff, a pilot balloon, and radiopaque markings along its length to measure the insertion distance. The tube sizes...
The ET tube comprises various components, including a standard adaptor to attach a bag-valve-mask (BVM) or ventilator, a cuff, a pilot balloon, and radiopaque markings along its length to measure the insertion distance. The tube sizes...
1.6K
Endotracheal Intubation II: Nursing Management
766
Endotracheal intubation is a critical procedure that can be lifesaving for many patients with respiratory distress or failure. The role of nursing in managing endotracheal tubes is pivotal, as it involves pre-intubation preparation, assisting during the procedure, and post-extubation care.
1. Nursing Care of Patients Before Intubation
Before the endotracheal intubation procedure, nurses play an essential role in ensuring the process goes smoothly. The nurses must be familiar with intubation...
1. Nursing Care of Patients Before Intubation
Before the endotracheal intubation procedure, nurses play an essential role in ensuring the process goes smoothly. The nurses must be familiar with intubation...
766
Cardiopulmonary Resuscitation II: ACLS Airway Management
19
Airway management is a key skill in emergency and critical care settings, as maintaining a clear airway is essential for adequate oxygenation and ventilation.Head Tilt-Chin Lift TechniqueThe head tilt-chin lift maneuver is an essential technique primarily used in patients without suspected cervical spine injuries. To perform this maneuver, one hand is placed on the patient’s forehead, and gentle pressure is applied backward to tilt the head. The fingertips of the other hand are positioned...
19
Oxygen Delivering System II: Venturi Mask and Transtracheal Oxygen
682
Oxygen therapy is a pivotal aspect of medical care, particularly for patients with respiratory ailments. Two prominent oxygen-delivering systems include the Venturi mask and the transtracheal oxygen catheter.
Venturi Mask
The Venturi mask, named after the Venturi effect, is designed to deliver precise oxygen concentrations. It consists of a large tube with an oxygen inlet that narrows down, causing a pressure drop that pulls air in through adjustable side ports. The mask is a lightweight,...
Venturi Mask
The Venturi mask, named after the Venturi effect, is designed to deliver precise oxygen concentrations. It consists of a large tube with an oxygen inlet that narrows down, causing a pressure drop that pulls air in through adjustable side ports. The mask is a lightweight,...
682
Endotracheal Tube Extubation
827
Endotracheal tube extubation is a critical procedure in weaning patients from mechanical ventilation. It involves physically removing the oral or nasal endotracheal (ET) tube, marking the final step in liberating a patient from ventilatory support.
Procedure
Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals....
Procedure
Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals....
827
Pneumonia V: Nursing management and Prevention
2.2K
Nursing management of pneumonia involves promoting airway patency, facilitating rest and conserving energy, encouraging fluid intake, maintaining nutrition, and educating patients.
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
2.2K


