Study On Related Factors And Fan Therapy Effects Of Dyspnea In Patients With Mechanical Ventilation In ICU

Objectives 1.To understand the current status and related influence factors of dyspnea among patients with mechanical ventilation in ICU.2.To explore the effect of facial cold stimulation-blowing intervention on dyspnea in patients undergoing mechanical ventilation in ICU.Methods 1.A convenience sample of 149 mechanically ventilated patients from a large public hospital in Fuzhou was surveyed by general information questionnaire,Vertical Analog Dyspnea Scale,Dyspnea Description Questionnaire,Pain Visual Analogue Scale,Anxiety Visual Analogue Scale and so on.To evaluate the current status of dyspnea among these patients.Non-conditional Logistic Regression analysis and other statistics methods were used to identify the influencing factors of dyspnea.2.A randomized controlled trial was conducted with mechanically ventilated patients conveniently selected from a large public hospital in Fuzhou.A total of 44 patients receiving mechanical ventilation were randomly assigned to experimental group or control group depending on the sequence generated by the online software.The subjects in the experimental group received facial cold stimulation-blowing intervention,which was delivered immediately,and last 5 minutes at least.But the total time depends on the patient's wishes.The control group was not given any intervention in the first 5 minutes,but after 5 minutes to give the same facial cold stimulation-blowing intervention,the total time depends on the patient's will as well.The patients were asked to answer the Vertical Analog Dyspnea Scale before and after the 5 minutes intervention.Heart rate,respiratory rate,and saturation of oxygen were obtained before and after the 5 minutes intervention.To examine the effects of facial cold stimulation-blowing intervention on the dyspnea level and physiological variables of mechanically ventilated patients in ICU.Results 1.Of the 149 patients with mechanical ventilation surveyed,83 had dyspnea and the incidence of dyspnea was 55.7%.The degree of dyspnea: mild(1~39mm)49 cases,accounting for 59.0%;moderate(40~60mm)15 cases,accounting for 18.1%;severe(61~100mm)19 cases,accounting for 22.9%.The words describe dyspnea as following distribution: 35(42.2%)air hunger,24(28.9%)breathing effort,13(15.7%)breath holding,5(6.0%)chest tightness,4(4.8%)sense of suppression in the chest,2(2.4%)suffocation.Non-conditional Logistic Regression analysis showed that the level of pressure support and anxiety were the influencing factors of dyspnea occur.Nonparametric test and Spearman correlation analysis showed that the severity of dyspnea was related to the degree of pain and the degree of anxiety.2.There is a significant difference(Z=?3.820,P < 0.01)between experimental group and control group in dyspnea.There is no significant difference(t=?1.522,P > 0.05)between experimental group and control group in respiratory rate.Between experimental group and control group in heart rate comparison,the difference was not statistically significant(t=?1.574,P > 0.05).Comparison between experimental group and control group in blood oxygen saturation,the difference was not statistically significant(t=?1.266,P > 0.05).Conclusions 1.Most of the mechanically ventilated patients in ICU are suffering from dyspnea,which is not affected by some objective factors.Clinical workers should take the initiative to ask patients,rather than just look,and then better to provide comfort care.2.The facial cold stimulation-blowing intervention can reduce the subjective feeling level of dyspnea in ICU patients with mechanical ventilation,and has no effect on physiological variables.It can provide an effective basis for the clinical development of comprehensive intervention measures to ease dyspnea.