| ObjectivesThis research adopted a prospective and randomized clinical trail toexplore the effect of application of the impact of air on artificial patient’ssubglottic secretions. In order to offer a reliablie reference basis for safe andeffective airway clearance techniques for mechanical ventilation patients.MethodsFrom December2011to December2013, select81patients who parallelartificial airway with mechanical ventilation in sever medical department of theFirst Affliated Hospital of Liaoning Medical University. They were randomlydivided into two groups. There are40in A group, another are41. The A groupadded air impact to clear subglottic secretion. B group use conventional sputumsuction and the At the same time, the effect of one suctioning was evaluated byauscultation of the moist rales, daily suction times, two consecutive sputumsuction time interval. Besides, ventilator associated pneumonia’s incidence, andthe time of occurrence of VAP was also recorded. In addation, patients’s heartrate, systolic blood pressure, diastolic blood pressure, pulse oxygen saturation,respiratory rate, tidal volume were measured and recorded before suction andafter suction. Complication such as mucosal trauma, airway obstruction werestill existed after suctioning were also recorded and compared. All of the datawere analyzed by SPSS17.0software statistical processing. P<0.05for thedifference was statistically significant. The measurement data of normal distribution data tox s, normal distribution using two independent samples.Two independent samples were compared using t test and2test.Results1. The two different ways of sputum aspiration of sputum suction effect:the A group compared another have better effect. which the number of sputumis reducing, two consecutive sputum suction’s time interval is extension, andmoist rales improve have higher score, the difference have statisticallysignificant (P<0.05).2. Compared to the mechanical ventilation events different ways of sputumaspiration: duration of mechanical ventilation (MV) with statistical significancedifferences between the A group (P<0.05); the days of patients in ICU havedifferences between two groups(P<0.05).3. The A group than another group, the incidence rate ofventilator-associated pneumonia in patients with mechanical ventilation and thetime of occurrence of VAP were also significant difference(P<0.05).4. Compared after sputum3minutes and before sputum suction to itself,two groups of patients with heart rate, systolic pressure, diastolic pressure, werestatistically significant (P<0.05), but the B group in the heart rate, systolicpressure, diastolic pressure increase was higher than that of A group.5. The A group in the blood oxygen saturation, respiratory rate and tidalvolum were statistically significant (P<0.05). B group had no statisticalsignificance in pulse arterial oxygen (P>0.05), tidal volum and respiratory rate(P<0.05). The A group increase tidal volume and pulse arterial oxygen aftersputum which was higher than the B group, the difference was statisticallysignificant (P<0.05).6. There was significant difference of the incidence of complicationsincluding mucosal trauma and airway obstruction between two groups(P<0.05). ConclusionsThis research confirmed that the impact of air can clear airway effectivelyand reduce the complications and adverse reaction, reduce the frequency ofsputum aspiration suction in daily times, extend the interval of two suction times,shorten the days of mechanical ventilation and intensive care unit days whichcompared with conventional suction. It is a safe and effective measures whichhave little influence on heart rate and blood pressure and can maintain oxygensituation, increase tidal volume and pulse arterial oxygen and maintainrespiratory stable. So it can be used in clinical practice. |
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