Application effect of critical care professional nursing team in the treatment of chronic obstructive pulmonary disease with respiratory failure

Abstract

Objective To observe the application effect of critical care professional nursing team applied to sequential mechanical ventilation in the treatment of chronic obstructive pulmonary disease (COPD) with respiratory failure. Methods Totally 80 patients of COPD with respiratory failure from May 2014 to April 2015 were divided into study group and control group by random number table method, 40 patients in each group. Study group was applied to critical care professional nursing team. Control group was given routine nursing. The two groups were treated for 4 weeks. The clinical indicators of positive end expiratory pressure (PEEP), pressure support ventilation (PSV), carbon dioxide partial pressure (PaCO2), oxygen partial pressure (PaO2), forced expiratory volume in one second (FEV1), heart rate, arterial systolic blood pressure, respiratory rate in two groups were compared. The clinical indicators such as the duration of the stay, the duration of the total ventilation, and the time of invasive ventilation, etc, in two groups were compared; and nursing satisfaction was also compared. Results Before nursing, there were no statistical differences between the study group and the control group in PaCO2, PaO2, FEV1, heart rate, systolic arterial blood pressure, respiration rate and PEEP, PSV indicators (t=0.04-0.63, P > 0.05). And after the intervention, the above indicators of the study group were (36.4±2.0) mmHg (1 mmHg=0.133 kPa), (94.7±4.8) mmHg, (45.2±16.0)%, (84.2±4.3) beats/min, (94.2±5.3) mmHg, (15.2±3.0) times/min, (3.6±1.2) mmHg, (10.2±2.0) ml and (48.5±5.3) mmHg, (88.3±4.1) mmHg, (36.9±14.1)%, (92.4±6.2) beats/min, (110.4±6.2) mmHg, (20.9±4.1) times/min, (4.2±1.6) mmHg, (13.9±2.4) ml in the control group. The differences were statistically significant (t=4.37-13.51, P < 0.01). After nursing care, the study group of patients with clinical indicators such as admission time, total duration of ventilation, the time of invasive ventilation were (12.5±1.5) d, (10.2±2.6) h, (5.2±2.1) h, while (18.2±2.6) d, (15.9±1.1) h, (7.9±2.9) h in the control group, the differences were statistically significant (t=12.01, 12.77, 4.77, P < 0.01).The nursing satisfaction rate was 80.0% (32/40) in the study group while 62.5% (25/40) in the control group, the difference was statistically significant (χ2=6.30, P < 0.01). Conclusions Sequential mechanical ventilation therapy and nursing care in patients with COPD can significantly improve the clinical symptoms, improve nursing satisfaction, it is worthy of clinical promotion. Key words: Pulmonary disease, chronic obstructive; Respiratory insufficiency; Critical care professional nursing team; Sequential mechanical ventilation