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Nasal continuous positive airway pressure (NCPAP) treatment of severe bronchiolitis and nursing observation


6O times / rain oxygen therapy in children with conduct NCPAP. Randomly divided into two groups, A group with NCPAP, a total of 26 patients, 15 males. 11 females, mean age 4 months; B group was treated with oxygen hood, a total of 36 cases, male 21, female l5, mean age 3.6 months. Both groups were age, sex, symptoms, and no other treatment differences. 1.2 Method 1.2.1A group with NCPAP treatment, positive end expiratory pressure 3 ~ 5cmH20, inspired oxygen concentration of 30% to 40%. 1.2.2B group appropriate choice of hood, oxygen flow 5L/min. 1.2.3 irritability, can not be quiet, the use of sedatives, the choice of luminal, chloral hydrate, chlorpromazine compound. With heart failure intravenous Cedilanid. 1.2.4 continuous monitoring, recording percutaneous oxygen saturation (SaO:), per hour, heart rate and respiratory rate; stable condition, stop oxygen, and note the calculated average heart rate and respiratory rate. 1-2.5 statistically. Mean comparison between groups using t test; rate by xz test, P = <O. o5, was statistically significant. 2 Results A group with no discomfort during NCPAP. Hood B Group 1 patients with symptoms of oxygen into the A group increased use NCPAP treatment. Two groups of children with heart rate, respiration, SaO other observed indicators in Table 1. In addition to the number of days outside the hospital, A group with NCPAP later. The clinical indicators with the B group there were significant differences, indicating good nasal continuous positive airway pressure (NCPAP) in the care of patients with severe bronchiolitis had good results. 3 3.1 good care items preparations 31,[link widoczny dla zalogowanych],1 prepare emergency supplies and medicines, are on board with the use of rescue with the check. Prepare, attract the device. 3.1.2 Connect the central oxygen supply, air compressor, air oxygen mixing device, humidifier, two nasal catheters, water-sealed bottle. Plus a good humidifier in sterile distilled water,[link widoczny dla zalogowanych], add water and seal the bottle a good scale tape drawn from the surface of the upper edge of the top-down vertical paste, turn on the switch power regulator according to the disease end-expiratory pressure and oxygen concentration . 120 in the stomach medicine shame breath dig CHINAMEDICALHERALD Table 1 Comparison of two groups observed the end of the pressure indicators of lung tissue according to children's compliance and adjust oxygen levels, decreased by the 5cmH20 to 3cmH20,[link widoczny dla zalogowanych], close observation of the closed pipe to ensure end-expiratory pressure in the regulation of the numerical. Inspired oxygen concentration adjusted according to oxygen levels, generally in the range 30% to 40%, the duration of high concentrations of oxygen can not exceed 2d. 3.2 The preparation and observation 3.2_1 several benefits to children on the warm radiant on stage. Gracefully position, supine, on the same set after CPAP to ensure the right size double nasal catheter, no leaks, no loss, no obstruction. Clear respiratory secretions, monitoring body temperature,[link widoczny dla zalogowanych], heart rate, respiration, SaO:, at any time to observe the changes. Timely processing. 3.2.2 hand care, close observation of children's complexion,[link widoczny dla zalogowanych], skin color, toilet case, whether the airway smooth, cyanosis with or without improvements, with or without abdominal distention occurred; necessary, turning over, shot back, suction, negative pressure Pressure not to attract too much, 60 ~ 100mmHg; frequently observed in the oxygen flow, end expiratory pressure; do not break pipes, detached. Local temperature of the gas pipeline to be controlled at 33 ~ 36 ℃, the water pipe to be excluded at any time. Add a bottle of water at any time wetting. To ensure that the appropriate wet pipe (tube with a layer of fine mist); 3.2_3 agitation were given sedation, were given to cardiac failure. Good basic care of children, such as skin, eyes, mouth, perineal care, timely replacement of the diaper, keeping the skin clean and dry. Observed rate of infusion to ensure the smooth progress of the treatment. Effect on the disposal and make a record. 3.2I4 do the work of disinfection and isolation, control, and out of accompanying persons, to prevent cross infection. Family members to do ideological work, so that with treatment and care. 4 Conclusion bronchiolitis in infants and young children common lower respiratory tract infections, especially in winter and spring is more common. The lesions caused by mucosal edema, mucus secretion, the bronchial smooth muscle spasm and luminal obstruction, the use of NCPAP, its clinical indexes of the B group were significantly different, with meticulous care. For the treatment of severe bronchiolitis to receive good results. 【
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