The best practice strategy of humidification oxygen therapy for patients with artificial airway during weaning from ventilation

Abstract

Objective To explore the better humidification oxygen therapy for patients with artificial airway from weaning to extubation, ensure the best humidification effect, keep airway unobstructed, shorten tubulization time and reduce the incidence of infection. Methods A total of 133 patients with artificial airway during weaning from ventilation admitted from March to December in 2016 in intensive care unit of the Second Affiliated Hospital of Chongqing Medical University were included in the study. They were divided into the experimental group (69 patients) and the control group (64 patients) by random lottery form. The experimental group was given improved combination device (venturi, heated humidifier and ventilator tube)during oxygen therapy for humidification and heating, while the control group was treated with oxygen therapy in endotracheal tube and continuous wet micro-injection pump 0.45% sodium chloride method. The heart rate, respiratory rate, blood oxygen saturation, offline time with tube, offline failure rate, sputum viscosity, sputum scab formation, irritant cough and pulmonary infection were compared between the two groups. Results The heart rate, respiratory rate, blood oxygen saturation and offline time with tube in the experimental group were (80.50±7.07) times/min, (17.38±1.92) times/min, 0.98±0.01, and (1.58±1.06) days, and which were (88.50±3.07) times/min, (21.38±1.51) times/min, 0.96±0.01 and (3.00±1.09) days in the control group. The differences were statistically significant (t = 2.268-4.782, P < 0.05 or 0.01). The offline failure (2 cases), sputum scab formation (3 cases), irritant cough (4 cases) and pulmonary infection(4 cases) were less than 8 cases, 12 cases, 20 cases,12 cases in control group. The differences were statistically significant (χ2=4.652-14.545, P < 0.05 or 0.01). The sputum viscosity of Ⅰ, Ⅱand Ⅲ were 5 cases, 52 cases and 12 cases in the experimental group, which were better than 13 cases, 11 cases and 40 cases in the control group. The difference was statistically significant (Z = 3.385, P < 0.01). Conclusions The improved oxygen therapy heated humidify strategy can not only achieve satisfactory humidification effect, but also improve the success rate of offline machines, shorten tubulization time, promote the comfort and tolerance of patients, and reduce the occurrence of infection. Key words: Airway management; Artificial airway; Patients during weaning from ventilation; Airway humidification; Oxygen inhalation therapy