An Analysis Based On Integrated Management Of Hospital Mechanical Ventilation In Children

Objective: Currently, it is hard to building pediatric intensive care unit(PICU) in the ascendant. No matter from the quantity or quality, which are farfrom being able to follow the growing medical requirement of children. As theessential medical unit of accepting various types of critically children likePICU, the basic skills for each Emergency Medicine Specialist standardizedventilator. Integrated management of mechanical ventilation in childrenrelated to the prognosis of critically ill children. Since2002, our hospital hasmore than ten years of clinical experience to establish the clinical use of PICUventilator. Due to the different circumstances of each PICU, ventilator clinicalproblems encountered in the process of using different. In this paper, aelaborately analysis of80cases of critically ill patients with mechanicalventilation, and to explore the status of our hospital PICU ventilator than toeach PICU valuable experience abroad, summarized the success of thepromotion will be unreasonable to improve and for the construction of thehospital PICU, the clinical use of the ventilator provides the latest theoreticaland practical guidance.Method: Select80cases as subject who had PICU mechanical ventilationin the treatment of1January2008to31December2013. Record children’sname, sex, age, time of onset, primary disease, hospitalization time; childrenmechanical ventilation indication, arterial blood gas analysis, ventilator modesselections and parameter settings, complications after the machine, and theresponse of complications; Record the results of ventilator-associatedpneumonia sputum culture and drug sensitivity of the experiment, thetherapeutic effect of clinical medicine, after recording situation, the moreventilator-associated complications in children discharged. Adverse eventswere recorded and responses that occur on machines process. Prepare before weaning, weaning conditions, the specific circumstances of the withdrawalmachine processes. Finally, all the recorded data using SPSS13.0statisticalsoftware for processing and analysis, count data applications χ2test,measurement data t test, the sample size less exact count data applicationsFisher, P less than0.05for the difference was statistically significant.Result:1A time segment grouping, group “A” of1January2008to31December2010in our hospital treatment in children with PICU applicationsventilator, group B is January1,2011to December31,2013hospitaltreatment in children with PICU applications ventilator, which constitute morethan the original disease, and age composition ratio by Χ2test, P>0.05, nostatistical difference. A, B are two of its top three primary disease with severepneumonia, congenital heart disease, pneumonia, severe brain disease. A, Binfant patients in the two groups of children are in the majority.2Onset of severe pneumonia in children, during mechanical ventilationmachine after midazolam sedation sustained by group A, unused sedation bygroup B, the two groups of children on board during the accident occurred offthe tube rate by χ2test, P <0.05, a significant difference. Arterial blood gasvalues before and after the two groups of children with PH machine, PaCO2values and Pa02values by t test, P <0.05, a significant difference.3Primary disease in children with congenital heart disease withpneumonia, PH value of blood grouping machines prior to the above analysis.A group of PH value≥7.25, group B PH value＜7.25. The cure rate andmortality rate by two groups of children χ2test, P≥0.05, no statisticaldifference. Computer time by t test, P <0.05, a significant difference.4Original onset of severe brain disease, Guillain-Barre syndrome,respiratory infections in children without the disease, the machine processomeprazole prevention of stress ulcer medication time grouping. Omeprazoletime≤5days for group A,6-10days for group B,≥11days for group C,the probability of occurrence of the three groups of children withventilator-associated pneumonia were analyzed Fisher exact test, P＜0.05, asignificant difference. 5Hoarseness after weaning, such as children with laryngeal edema,stridor, epinephrine nebulizer treatment group A, the application of nebulizedbudesonide treatment group B, the duration of the two groups of children withlaryngeal edema, respiratory rate before and after the atomization t test, P≤0.05, a significant difference. Heart rate by t test, P＞0.05, no significantdifferenceConclusion:1Hospital PICU primary disease for nearly six years toapply ventilator therapy in critically ill children with no significant change.Severe pneumonia, congenital heart disease with pneumonia, severe braindisease is still a threat to children’s health and life of the province of majordiseases. Critically ill infants is still a major crowd.2Children with severe pneumonia during mechanical ventilation usingmidazolam sedation may be effective in preventing adverse events off the tubeand helps restore normal arterial blood gases.3Children with congenital heart disease and pneumonia morning machinesshould be on board before the PH value≥7.25children compared with PHvalues＜7.25were machines on the timing of shortening.4The longer the children on board omeprazole prevention of stress ulcer, thehigher the risk of ventilator-associated pneumonia.5Weaning children with laryngeal edema occurs, epinephrine aerosol therapymore effective than budesonide atomization.