Effect Of Chest Physiotherapy On Ventilator-associated Pneumonia

Objective:Ventilator-associated pneumonia is easy to occur in the patients with mechanical ventilation,which affects the overall prognosis of patients.In this study,chest physiotherapy was applied to patients with ventilator-associated pneumonia to explore the effects of chest physiotherapy on mechanical ventilation time,the time stay in the ICU,oxygenation index,inflammatory index and adverse events in patients with ventilator-associated pneumonia,and to evaluate the effect of chest physiotherapy on the treatment of ventilator-associated pneumonia.To evaluate the safety of chest physiotherapy therapy on patients with ventilator-associated pneumonia.Methods:According to the inclusion and exclusion criteria,selected 100 patients with ventilator-associated pneumonia were admitted to the intensive care unit of Xiangya Hospital Central South University from January 2018 to June 2019,They were randomly divided into control group and observation group with 50 cases in each group according to the random number table.The control group was treated with routine treatment.On the basis of routine therapy,the observation group received the chest physiotherapy treatment such as airway clearance training,respiratory muscle training and body position therapy,The training program was jointly formulated by responsible physician and nurse of the patient in ICU,rehabilitation physician and rehabilitation therapist,and chest physiotherapy therapy was carried out by rehabilitation therapist.the score of acute physiology and chronic health status scoring system(APACHE ?),minimum PaO2/FiO2,white blood cell count,C-reactive protein,procalcitonin and CPIS were compared between the two groups before and after treatment.And the time of staying in ICU,the duration of mechanical ventilation and total effective rate were also compared between the two groups,As well as adverse events during chest physiotherapy treatment in observation group was recorded and analyzed.Results:1.During the intervention,5 patients in the observation group withdrew from the study because that they did not cooperate with the treatment,and 4 patients in the observation group dropped out of the study because of the change of their condition.6 patients in the control group withdrew from the study due to changes in their conditions.Finally,41 patients in the observation group and 44 patients in the control group were included in the data analysis.2.There was no significant difference in APACHE ? score,white blood cell count C-reactive protein,procalcitonin CPIS score and minimum PaO2/FiO2 between the two groups before treatment(P>0.05).3.The APACHE ? score,white blood cell count C-reactive protein,procalcitonin CPIS score of the two groups after treatment were significantly lower than those before treatment(P<0.05).The lowest PaO2/FiO2 was significantly higher than that before treatment(P<0.05).After treatment,observation group's APACHEIIscore,WBC,PCT,CRP and CPIS were lower than those of control group,observation group's lowest PaO2/FiO2 was higher than that of control group's,There were significant difference between the two groups(P<0.05).4.The hospitalized time in ICU and the duration of mechanical ventilation of observation group were shorter than those of control group,the total effective rate of the observation group obviously higher than that of control group(92.50%VS 70.00%).There were significant difference between the two groups(P<0.05).5.Patients in the observation group did not experience complications such as limb injury,ventilator pipeline prolapse,falling down from bed,severe arrhythmia and significant fluctuation of respiration and circulation during chest physiotherapy therapy.Conclusion:Chest physiotherapy treatment can reduce the inflammatory index of patients with ventilator-associated pneumonia,shorten the time of mechanical ventilation and ICU hospitalization,and improve the total effective rate of treatment.Under the condition of grasping the indications and contraindications of chest and lung physiotherapy.It is safe and effective to apply chest physiotherapy treatment to the patients with ventilator-associated pneumonia,and it is worthy to spread in clinic.