Effect of prone position ventilation combined with fiberoptic bronchoscopy in the treatment of coma patients with atelectasis

doi:10.3969/j.issn.1004-583X.2023.05.006

Abstract

Abstract:

Objective To investigate the therapeutic effect of prone position ventilation combined with fiberoptic bronchoscopy on coma patients with atelectasis. Methods A total of 36 patients hospitalized in the surgical intensive care unit (ICU) of our hospital from June 2021 to May 2022 due to severe brain injury, spontaneous cerebral hemorrhage, intracranial aneurysm rupture and hemorrhage who were unable to withdraw the ventilator due to pulmonary infection and atelectasis were retrospectively analyzed. Their primary diseases tended to be stable. They were randomly divided into observation group and control group, with 18 in each group. Patients in observation group were managed by conventional treatment combined with prone position ventilation and fiberoptic bronchoscopy, and those in control group were managed by conventional treatment combined with fiberoptic bronchoscopy. Imaging data (chest computed tomography [CT]/digital radiography [DR]), arterial blood gas test data, ventilator parameters, mechanical ventilation time, use of antibiotics, ICU hospitalization time, and complications before and after treatment in both groups were collected. Results After treatment, the atelectasis of all patients in observation group was improved, with the significantly increased oxygenation index. Among them, six cases had pressure sores of varying degrees, and eventually cured. Other serious complications in observation group were not reported. In the control group, twelve patients had improved atelectasis and increased oxygenation index. The improvement rate of atelectasis in the observation group was significantly higher than that in the control group (100% vs 67%), suggesting that the treatment of prone position ventilation combined with fiberoptic bronchoscopy was more beneficial to atelectasis than conventional treatment. Conclusion Prone position ventilation combined with fiberoptic bronchoscopy is an effective treatment to coma patients with atelectasis.

Key words: atelectasis, coma, prone position, bronchoscopy

CLC Number:

R563.4

Feng Yang, Wang Xiangmeng. Effect of prone position ventilation combined with fiberoptic bronchoscopy in the treatment of coma patients with atelectasis[J]. Clinical Focus, 2023, 38(5): 423-427.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2023.05.006

https://huicui.hebmu.edu.cn/EN/Y2023/V38/I5/423

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References 26

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组别	例数	性别 (男/女)	年龄 (岁)	APACHE Ⅱ 评分(分)	GCS评分 (分)
观察组	18	13/5	59.94±12.64	19.00±3.33	6.01±1.09
对照组	18	12/6	57.83±13.36	20.33±3.69	5.89±1.49
χ²/t值		2.778	0.487	-1.138	0.256
P值		0.067	0.977	0.435	0.345

组别	例数	性别 (男/女)	年龄 (岁)	APACHE Ⅱ 评分(分)	GCS评分 (分)
观察组	18	13/5	59.94±12.64	19.00±3.33	6.01±1.09
对照组	18	12/6	57.83±13.36	20.33±3.69	5.89±1.49
χ²/t值		2.778	0.487	-1.138	0.256
P值		0.067	0.977	0.435	0.345

组别	例数	氧合指数(mmHg)
组别	例数	治疗前	治疗后
观察组	18	110.25±17.15	205.73±26.73^*
对照组	18	111.48±16.68	187.71±11.81^*
t值		-0.315	2.618
P值		0.755	0.013

组别	例数	氧合指数(mmHg)
组别	例数	治疗前	治疗后
观察组	18	110.25±17.15	205.73±26.73^*
对照组	18	111.48±16.68	187.71±11.81^*
t值		-0.315	2.618
P值		0.755	0.013

组别	例数	PaO₂(mmHg)
组别	例数	治疗前	治疗后
观察组	18	59.61±6.24	92.44±7.16^*
对照组	18	58.94±6.84	76.44±6.71^*
t值		0.507	6.777
P值		0.616	0.000