Research On Application Of Hypertonic Saline Associated With Different Dosage Of Mucosolvan Nebulized To Early Tracheostomy Airway Management

Objectives1,To investigate the effectiveness and feasibility about hypertonic saline associated with mucosolvan nebulized on rabbits of early tracheotomy.2,To discuss early tracheostomy airway protection of mucosolvan at different doses at a constant hypertonic condition.MethodsThe establishment of rabbit tracheotomy model was applied to the study.34 rabbits were randomly classified into 5 groups: normal control group(A), isotonic saline nebulized group(B), simply hypertonic saline nebulized group(C), hypertonic saline associated with mucosolvan(2mg/kg.d) nebulized group(D) , hypertonic saline associated with mucosolvan(5mg/kg.d) atomized group(E).At seven days after tracheotomy, the level of respiratory rate,heart rate and oxygenation were monitored and sputum was tested in the course of atomization ,TNF-a and IL-8 levels in bronchial lavage lung were delected by radioimmunity, mucosa-cilia was harvested to observed the regional changes by light microscopy and scanning electron microscopy.Results1,Airway seurity: The airway security of each hypertonic aerosol groups was better than isotonic group after nebulization; the values of respiratory rate and heart rate in the hypertonic aerosol group with mucosolvan (5mg/kg.d) was lower than the in ones simple hypertonic saline group and in the hypertonic aerosol group with mucosolvan(2mg/kg.d),their oxygenation level had no significant differences; There were no significant differences between the simple hypertonic saline group and the the hypertonic aerosol group with mucosolvan(2mg/kg.d).2,Sputum viscosity: The values of all of hypertonic aerosol groups were lower than the one of isotonic group.With mucosolvan dose increased, sputum viscosity were reducing.3,Viable organism ratio in sputum: The values of all of hypertonic aerosol groups were lower than the one of isotonic group,at the same time there were no significant differences in all of hypertonic aerosol groups.4,Cell inflammatory cytokine levels: The values of hypertonic saline groups were lower than the one of isotonic saline group; the hypertonic aerosol group with mucosolvan(5mg/kg.d) was lower than the pure hypertonic saline group and the hypertonic aerosol group with mucosolvan(2mg/kg.d);there were no significant differences between the simple hypertonic saline group and the hypertonic aerosol group with mucosolvan (2mg/kg.d).5,Mucosal injury in pathology: the extents of injury in all of hypertonic aerosol groups were lower than in isotonic saline group; With mucosolvan dose increased, the extent of mucosal injury were reducing.Conclusions1,The mucous membrane of airway in the earlier period of tracheostomy has shown on hypersecretion,high edema and high inflammation levels, atomization of hypertonic solution with 3% NaCL isotomic equivlent can play an effective role both in inhibiting inflammation and in promoting expectoration and in maintaining normal oxygenation level..2,At constant osmotic conditions, some dosage of Mucosolvan and hypertonic saline can be cooperated to confront the high inflammatory status in the early period of tracheotomy. Mucosolvan atomization shows the charaeteristic of dose dependent:mucosolvan(2mg/kg.d)and hypertonic saline can be coordinated to promote sputum dilution; Mucosolvan(5mg/kg.d) used to exert bronchial relaxation and restrict expression of inflammatory factors ,which will enhance the safety of drug intake, inhabit the airway inflammation and promote airway protection.