Effects of severe ultrasound-guided individualized respiratory management on pulmonary ventilation in NICU children with severe respiratory disease

doi:10.11958/20251479

Abstract

Abstract:

Objective To explore the effect of ultrasound-guided individualized respiratory management on pulmonary ventilation in neonates with severe respiratory diseases in neonatal intensive care unit (NICU). Methods A total of 96 children with severe respiratory disease in NICU of the hospital were selected as research subjects. According to the random number table method, they were divided into the observation group and the control group, with 48 cases in each group. The control group was treated with routine respiratory management, and the observation group was treated with severe ultrasound-guided individualized nursing management on the basis of the control group. The clinical indexes, blood gas analysis and respiratory dynamics indexes including arterial partial pressure of oxygen [p(O₂)], partial pressure of carbon dioxide [p(CO₂)], arterial blood pH, airway resistance, chest lung compliance and severity of disease [pediatric critical illness score (PCIS), simple neonatal acute physiology score II (SNAP-II)] and occurrence of complications were compared between the two groups before and after intervention. Results The mechanical ventilation time, antipyretic time, white blood cell count (WBC) recovery time, ICU stay and hospitalization time were significantly shorter in the observation group than those in the control group (P<0.05). After intervention, p(O₂), pH and chest lung compliance were significantly increased in the two groups (P<0.05), while p(CO₂) and airway resistance were significantly decreased (P<0.05). Moreover, the improvement was better in the observation group than that of the control group. After intervention, the PCIS scores were significantly increased in both groups (P<0.05), while the SNAP-II scores were significantly reduced (P<0.05), and the improvement was better in the observation group than that of the control group (P<0.05). The total complication rate was significantly lower in the observation group than that in the control group (P<0.05). Conclusion Severe ultrasound-guided individualized respiratory management can significantly enhance the pulmonary ventilation of NICU children with severe respiratory disease, improve the blood oxygen status and accelerate the improvement of disease condition.

Key words: ultrasound, intensive care unit, pulmonary ventilation, neonates, respiratory management

CLC Number:

R722.12，R473

Figures/Tables 5

References 20

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组别	男性	胎龄/周	出生体质量/kg	分娩方式		新生儿疾病类型
组别	男性	胎龄/周	出生体质量/kg	顺产	剖宫产	重症感染性肺炎	呼吸衰竭	呼吸窘迫综合征	其他
对照组	20（41.7）	33.65±2.51	2.04±0.41	22（45.8）	26（54.2）	21（43.8）	10（20.8）	13（27.1）	4（8.3）
观察组	23（47.9）	33.32±2.43	1.97±0.45	27（56.3）	21（43.7）	18（37.5）	13（27.1）	12（25.0）	5（10.4）
χ²或t	0.379	0.654	0.797	1.042		0.773

组别	男性	胎龄/周	出生体质量/kg	分娩方式		新生儿疾病类型
组别	男性	胎龄/周	出生体质量/kg	顺产	剖宫产	重症感染性肺炎	呼吸衰竭	呼吸窘迫综合征	其他
对照组	20（41.7）	33.65±2.51	2.04±0.41	22（45.8）	26（54.2）	21（43.8）	10（20.8）	13（27.1）	4（8.3）
观察组	23（47.9）	33.32±2.43	1.97±0.45	27（56.3）	21（43.7）	18（37.5）	13（27.1）	12（25.0）	5（10.4）
χ²或t	0.379	0.654	0.797	1.042		0.773

组别		NICU入住时间			住院时间
对照组		9.31±2.07			16.02±3.22
观察组		7.52±1.76			13.55±2.58
t		4.564^＊＊			4.160^＊＊
组别	机械通气时间		退热时间	WBC恢复正常时间
对照组	5.62±1.71		5.11±1.46	8.11±2.03
观察组	4.56±1.46		4.23±1.34	6.33±1.68
t	3.266^＊＊		3.076^＊＊	4.680^＊＊

组别		NICU入住时间			住院时间
对照组		9.31±2.07			16.02±3.22
观察组		7.52±1.76			13.55±2.58
t		4.564^＊＊			4.160^＊＊
组别	机械通气时间		退热时间	WBC恢复正常时间
对照组	5.62±1.71		5.11±1.46	8.11±2.03
观察组	4.56±1.46		4.23±1.34	6.33±1.68
t	3.266^＊＊		3.076^＊＊	4.680^＊＊

组别		p（O₂）/mmHg
组别		干预前				干预后			t
对照组		61.34±6.06				86.72±7.43			18.339^＊＊
观察组		62.32±5.27				92.44±7.78			22.207^＊＊
t		0.845				3.684^＊＊
组别		p（CO₂）/mmHg
组别		干预前				干预后			t
对照组		57.67±4.87				46.77±4.89			10.942^＊＊
观察组		58.33±5.22				41.28±4.21			17.614^＊＊
t		0.641				5.895^＊＊
组别				动脉血pH
组别				干预前	干预后			t
对照组				7.20±0.11	7.35±0.14			5.837^＊＊
观察组				7.17±0.12	7.47±0.16			10.392^＊＊
t				1.277	3.911^＊＊
组别			气道阻力/[cmH₂O/（L·s）]
组别			干预前				干预后			t
对照组			13.16±3.38				10.46±2.71			5.094^＊＊
观察组			13.68±3.44				9.13±2.66			7.249^＊＊
t			0.747				2.427^＊
组别	胸肺顺应性/（mL/cmH₂O）
组别	干预前						干预后				t
对照组	40.66±9.88						46.87±10.74				2.948^＊＊
观察组	41.33±10.22						55.46±11.21				6.175^＊＊
t	0.311						3.833^＊＊