Clinical Analysis Of Prognosis Value Of The Bundle Treatment On Encephalopathy Patients With Ventilator-associated Pneumonia

Objective: To investigate the prognostic value of the "bundle" treatment onencephalopathy patients with ventilator-associated pneumonia. Method:Randomlydivided72mechanically orotracheal ventilated patients admitted to ICU from September2010to March2012into experimental and control groups.37patients in experimentalgroup adopted "bundle" treatment,35patients in control group took conventional treatment.The two groups were given the same basic treatment, including (1) Active treatment of theprimary disease;(2) Protecting the vital organs,.(3) Trying to keep elevating head upwardto prevent hypostatic pneumonia;(4) Rational use of antibiotics;(5) Daily makingwithdrawal assessment: try to early weaning off;(6) Prevention of deep veinthrombosis;(7) Avoid cross infection in hospital setting;(8) Strengthen the wards andmedical equipment management. On the basis of the above treatment, the experimentalgroup was given the “bundle” treatment, including:(1) every six hours cleaning pharynxthrough alternately given2%chlorhexidine solution and4%sodium bicarbonate;(2) dailyvisual suction by means of application of fiberoptic bronchoscopy, and keep airway clean;(3) According to the particular blood sugar change, given intravenous infusion of insulinby micro-pump to control blood sugar below10mmol/L;(4) given intravenous infusion ofmidazolam and morphine for sedation and analgesia, and implementation of wake-up planone time every day, try to minimize the time of sedation and analgesia. Result: the lengthof stay11.93±6.25days in experimental group, and that of in control group18.08±7.53days (P=0.002).(2) the cost of stay6.87±3.25thousand in experimental group,and that of in control group9.58±3.82thousand (P=0.007)Conclusion:“bundle” treatmentcan reduce significantly the length of hospital stay, and hospitalization cost, but can’t reduce the28-days mortality in encephalopathy patients with ventilator-associatedpneumonia. Nevertheless, the role of the role of the "bundle" treatment should be affirmedin ICU.