Objectives To investigate the effects of artificial nose, Venturi device+thermostatic humidification T-tube, Venturi device+thermostatic humidification T-tube+PEEP valve in patients with tracheotomy in ICU.
Design: Cohort study.
Setting: Tertiary academic medical center.
Patients: A total of 215 patients were engaged in this study. Clinical and laboratory examination data were used to determine the heating and humidification efficiency of 3 different methods.
Methods: We conducted randomized controlled trial. Patients who successfully weaned from mechanical ventilation were enrolled, and every patient was randomized to receive one of the above three interventions. Three groups of patients were compared in terms of vital signs, the effect of artificial airway heating and humidification, and blood gas indicators. Basic patient data (age, gender, mechanical ventilation duration, ICU stay, disease type) were recorded. Vital signs include heart rate, blood pressure, respiratory rate, oxygen saturation; The effect of heating and humidifying the artificial airway were defined as the number of sputum suction and coughing within 24 hours, sputum characteristics, whether there is bloody sputum formation, whether there is phlegm callus formation; Blood gas indicators include pH, oxygen partial pressure, carbon dioxide partial pressure, lactic acid, residual base, and bicarbonate.
Results: In terms of the heating and humidification effect of patients in ICU, the heating and humidification effect of the Venturi device+T-tube method and the Venturi device+the T-tube +PEEP valve method were significantly superior to those of artificial nasal method (sputum suction number: P =0.0001; sputum scab: P =0.03; Number of cough: P =0.007).
SpO2 was significantly higher (P =0.004) in the Venturi device+T tube+PEEP valve than that in the Venturi device+T tube.
Conclusion: Compared with the artificial nose method, the T-piece+venturi device and thermostatic heating and humidifying T-tube +PEEP valve method is better. In terms of improving oxygenation, the Venturi device and the thermostatic humidification T tube +PEEP valve could improve the patient's oxygen sum more than the Venturi device and the thermostatic humidification T tube.