Clinical Observation On Flushing Aerocyst Of Artificial Airway With Tanreqing Injection And Prevention Of Ventilator Associated Pneumonia

Objective To compare the two ways to flush aerocyst of artificial airway in matched groups, one is with tanreqing injection.the other is normal saline and to compare the bacteria content and spectrum of the residual liquid on aerocyst in the two groups, analyzing VAP occurrence of the patients in matched groups. The aim is to find effective ways to prevent Ventilator Associated Pneumonia by research on this project.Methods Selected patients were put into flushable endotracheal intubation or tracheostomy tube and mechanical ventilation time was above48hours. Besides, acute physiology and chronic health conditions (APACHE Ⅱ) ratings were between20-30partition, except for those who had clear lung infection before put into intubation or those patients who caught with pneumonia or other infectious diseases with48hours. The patients were randomly divided into two groups. Experimental group consisted of29cases,18males and11females; ages from59to91years old,the average age is77.74±13.28. The patients in this group were flushed the aerocyst with10ml tanreqing injection once every12hours. The matched group consisted of30cases,19males and11females; ages from59to93years old, the average age is77.35±13.04. This group applied10ml0.9%normal saline to flush aerocyst once every12hours. Record residual liquid volume, traits, bacteria content of patients before every flush and Record patients’general condition, body temperature change everyday; Check the sternum once a week and check once every2days for white blood cells, PCT (calcitonin original) and CRP (CRP), etc. Sampling the residual liquid on aerocyst and the specimens of lower respiratory for bacterial etiology respectively, observing the time of VAP occurrence, and incidence of statistics. Comparing the ratings of the cases in the two groups in terms of gender, age, acute physiology and chronic health conditions (APACHE Ⅱ), the difference was of no statistical significance (P>0.05).Results After two weeks’ treatment, comparing the VAP occurrence of the two groups, the experimental group was lower than matched group and the difference was of statistical significance(P=0.048). The amount of bacteria of residual liquid on aerocyst in experimental group reduced significantly after two weeks’treatment (P<0.001), while the matched group was of no statistical difference (P>0.05).Conclusion The occurrence of VAP of experimental group were lower than the matched group. Also, The amount of bacteria of residual liquid on aerocyst in experimental group reduced significantly after two weeks’ treatment. Therefore, tanreqing injection has inhibitory effect to the bacterial biofilm, and also has antiviral, anti-inflammatory, antipyretic effect and so on.