Abstrait

Application of cluster airway management to patients with severe inhalation injury

Wei-Wei Wu, Shi-Feng Wu, Jia-Ao Yu, Cheng Chi, Duo Cai, Dan Cheng, Hong-Yan Li

Objective: To investigate the effect of cluster airway management in patients with severe inhalation injury.

Methods: Sixty-seven patients who suffered from severe inhalation injury and underwent a tracheotomy between June 2013 and June 2016 were selected for this study. The developed cluster airway management program included the airway assessment and emergency treatment, asphyxia detection and treatment, body position management, sputum suction care, subglottic suction, airway humidification, airbag management, tracheal tube care, tracheotomy site care, thoracic lung care, oral care, management of respiratory tracts, and medical environmental infections control. Observation group consisted of 35 patients hospitalized between January 2015 and June 2016 and treated with implementation of the cluster airway management. Control group consisted of 32 patients hospitalized between June 2014 and December 2015 and not treated with the cluster airway management. The evaluation of the two groups of patients included daily arterial blood gases (ABG) analysis indicators (pH, PO₂, PCO₂, Lac) and oxygenation index. Blood oxygen saturation (SpO₂) was measured on the days 1, 3, 6, 9, and 12 of hospitalization.

Results: There were significant differences in the levels of pH, PO₂, Lac and SpO₂ between the two groups on the days 6 and 9 of hospitalization (P<0.05* or P<0.01**). The level of PCO₂ was significantly different between the two groups on the days 3, 6 and 9 of hospitalization (P<0.01**). There were statistical differences in the oxygenation index between the two groups on the days 9 and 12 of hospitalization (P<0.05* or P<0.01**). There were significant differences in patients’ sputum characteristics between the two groups during the first, second and third weeks of hospitalization (P<0.01**).

Conclusion: Application of cluster airway management can effectively improve the oxygenation status of patients and the viciousness of patient’s sputum affected by an inhalation injury, and reduces the incidence rate of pulmonary infections.