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Objective To observe the effect of early enteral nutrition (EEN) on nutritional indicators and clinical outcomes in patients with severe heart failure undergoing mechanical ventilation. Methods Thirty-four patients with severe heart failure (grade Ⅲ-Ⅳ of cardiac function) and pulmonary infections undergoing mechanical ventilation admitted to intensive care unit (ICU) of Second Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine from May 2017 to April 2018 were enrolled. They were randomly divided into EEN group and delayed enteral nutrition (DEN) group. Both groups were given routine treatment, including mechanical ventilation, improvement of cardiac function, anti-infection, protection of vital organ function, regulation of blood sugar and adjustment of electrolyte and acid-base balance. The patients in EEN group received enteral nutrition (EN) within 48 hours after ICU admission, and in DEN group, EN was started after the patients had spent the early stage of stress and had stable vital signs (48 hours after ICU admission). The changes in serum B-type natriuretic peptide (BNP), C-reactive protein (CRP), nutritional indicators and liver function indicators at ICU admission and 7 days after treatment were compared between the two groups. The time needed for patients to reach EN target, duration of mechanical ventilation, length of ICU stay, and the 28-day mortality were recorded, and complications were observed. Results There was no significant difference in serum BNP, CRP, nutritional indicators or liver function indicators at ICU admission between the two groups. After treatment for 7 days, BNP and CRP in both groups were decreased significantly as compared with those at ICU admission [BNP (ng/L): 592.1±370.9 vs. 2 517.7±1 163.4 in EEN group, 621.9±418.8 vs. 2 251.5±1 006.8 in DEN group; CRP (mg/L): 46.0±19.6 vs. 59.8±22.5 in EEN group, 40.5±18.8 vs. 61.2±24.6 in DEN group, all P < 0.05], pre-albumin (PA) and transferrin (TF) were significantly increased [PA (g/L): 0.18±0.05 vs. 0.15±0.06 in EEN group, 0.17±0.04 vs. 0.12±0.06 in DEN group; TF (g/L): 1.6±0.4 vs. 1.5±0.4 in EEN group, 1.7±0.5 vs. 1.4±0.5 in DEN group, all P < 0.05]. However, there was no significant difference in the above indicators after treatment between the two groups (all P > 0.05). There was no significant change in liver function after treatment in both groups. The EN treatment was successfully completed in both groups. Some patients developed abdominal distension and diarrhea in varying degrees, which were alleviated by slowing down the infusion rate, supplemented by gastrointestinal motility drugs and intestinal flora adjustment drugs. The time needed to reach EN target in EEN group was significantly earlier than that in DEN group (hours: 42.4±10.2 vs. 53.8±17.1, P < 0.05), the duration of mechanical ventilation (days: 14.2±8.7 vs. 13.4±7.9), the length of ICU stay (days: 17.8±6.7 vs. 18.3±5.6) and 28-day mortality [5.9% (1/17) vs. 11.8% (2/17)] showed no significant difference as compared with those in DEN group (all P > 0.05), and it did not increase the incidence of aspiration pneumonia [23.5% (4/17) vs. 17.7% (3/17), P > 0.05]. Conclusion EEN could help to achieve nutritional goals as soon as possible, improve the nutritional status of the body, and provide conditions and basis for further treatment of severe heart failure patients.
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Objective To analyze the clinical observation and psychological intervention of the vasoactive drugs in the treatment of severe heart failure under ECG monitoring. Methods 100 patients with severe heart failure treated in our hospital from February 2015 to August 2016 were selected as the research object. They were randomly divided into the control group and the experimental group, with 50 patients in each group. The control group was treated with conventional treatment, including oxygen therapy and cardiac and diuretic therapy, the experimental group were given ECG monitoring and infusion of vasoactive drug therapy, using sodium nitroprusside drugs, and psychological intervention on the mental status of patients, strengthen communication and exchanges with patients, increasing confidence in treatment and the treatment compliance of patients. The clinical indexes of the experimental group and the control group were compared and analyzed. Results After the corresponding treatment, the number of invalid cases in the experimental group was 5 cases, the number of effective cases was 30 cases, and the number of effective cases was 15 cases. The number of invalid cases in the control group was 9 cases, the effective number was 27 cases, and the effective cases were 14 cases. The effective rate of treatment in the experimental group was 90%, which was significantly higher than that in the control group, and the effective rate was 82%, with statistical difference (P<0.05). There were no obvious adverse reactions in the experimental group and the control group. Conclusion The application of vasoactive drugs under ECG monitoring in the treatment of severe heart failure has better clinical efficacy and higher safety.
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Objective To study the clinical efficacy of low dose thyroxine combined with irbesartan hydrochlorothiazide in the treatment of elderly patients with severe heart failure. Methods 60 cases of elderly patients with severe heart failure who were admitted from January 2015 to December 2016 were selected as the research object in this study. They were randomly divided into control group and experimental group, each group was divided into two groups, each with a total of 30 cases. Patients in the control group were treated with conventional therapy, while the experimental group was treated with low dose thyroxine combined with irbesartan and hydrochlorothiazide. Comparative analysis of clinical efficacy of the experimental group and control group. Results After treatment, the total effective number of patients in the experimental group was 26 cases, the effective rate was 86.7%. The total effective number of patients in the control group was 21 cases, the effective rate was 70.0%. Therefore, the effective rate of the experimental group was significantly higher than that of the control group, with statistical difference (P<0.05). After treatment, the experimental group of patients with left ventricular ejection fraction index, four triiodothyronine and three triiodothyronine levels were significantly higher than those before treatment, the control group of patients with left ventricular ejection fraction were significantly higher than before treatment, with statistical difference (P<0.05). Conclusion Low dose thyroxine combined with irbesartan hydrochlorothiazide in the treatment of elderly patients with severe heart failure has better clinical effect, can improve the therapeutic effect in a certain extent, with further clinical promotion and application significance.intervention in two groups. Results The clinical intervention effect of the observation group was better than that of the control group, the stability of the tumor focus, the degree of pain, the quality of life and other aspects were better than the control group, the difference between the two groups was statistically significant (P<0.05). Conclusion Patients with advanced non-smal cell lung cancer chemotherapy choose psychological intervention compound sophora injection combined treatment effect is remarkable, which can effectively improve the patient's clinical symptoms and quality of life.
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Objective To study the clinical efficacy of low dose thyroxine combined with irbesartan hydrochlorothiazide in the treatment of elderly patients with severe heart failure.Methods 100 cases of elderly patients with severe heart failure treated in our hospital from January 2013 to December 2016 were selected as the research object in this study.They were randomly divided into control group and experimental group, with 50 cases in each group.Patients in the control group were treated with conventional therapy, while the experimental group was treated with low dose thyroxine combined with irbesartan and hydrochlorothiazide.The clinical efficacy of the two group were compared and analyzed.Results After the corresponding treatment, the total effective rate of the experimental group was 88.0%,significantly higher than that of the control group(70.0%), the difference was statistically significant(P<0.05).After treatment, the experimental group of patients with left ventricular ejection fraction index, four triiodothyronine and three triiodothyronine levels were significantly higher than those before treatment, the control group of patients with left ventricular ejection fraction were significantly higher than before treatment, the difference was statistically significant(P<0.05).Conclusion Low dose thyroxine combined with irbesartan hydrochlorothiazide in the treatment of elderly patients with severe heart failure has better clinical effect, can improve the therapeutic effect in a certain extent, with further clinical promotion and application significance.
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Objective To study the clinical efficacy of irbesartan hydrochlorothiazide combined with small dose thyroxine in the treatment of severe heart failure in the elderly. Methods 100 elderly patients with severe heart failure were selected as the research object (from January 2013 to December 2016). They were randomly divided into the control group and the experimental group, with 50 patients in each group. Patients in the control group received routine treatment, including diuretic therapy, cardiac treatment, and anti heart failure treatment. The experimental group was treated with low-dose thyroxine combined with irbesartan and hydrochlorothiazide on this basis. The clinical effects of the two groups were compared and analyzed. Results After the corresponding treatment, the number of invalid cases in the experimental group was 6 cases, 16 cases were effective, 28 cases were effective,and the total effective number was 44 cases. In the control group, the number of invalid cases was 15. The effective rate of the treatment group was 88.0％, which was significantly higher than that of the control group 70％, which was statistically significant (P<0.05). After treatment, the left ventricular ejection fraction, the level of four and three, and the level of serum thyroid stimulating hormone in the experimental group were significantly higher than those before treatment, with statistical difference (P<0.05). Conclusion Small dose thyroxine combined with irbesartan and hydrochlorothiazide is effective in the treatment of severe heart failure in elderly patients, and can significantly improve the heart function of patients, and has the significance of further clinical promotion.
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Objective To analyze the clinical observation and psychological intervention of the vasoactive drugs in the treatment of severe heart failure under ECG monitoring. Methods 100 patients with severe heart failure treated in our hospital from February 2015 to August 2016 were selected as the research object. They were randomly divided into the control group and the experimental group, with 50 patients in each group. The control group was treated with conventional treatment, including oxygen therapy and cardiac and diuretic therapy, the experimental group were given ECG monitoring and infusion of vasoactive drug therapy, using sodium nitroprusside drugs, and psychological intervention on the mental status of patients, strengthen communication and exchanges with patients, increasing confidence in treatment and the treatment compliance of patients. The clinical indexes of the experimental group and the control group were compared and analyzed. Results After the corresponding treatment, the number of invalid cases in the experimental group was 5 cases, the number of effective cases was 30 cases, and the number of effective cases was 15 cases. The number of invalid cases in the control group was 9 cases, the effective number was 27 cases, and the effective cases were 14 cases. The effective rate of treatment in the experimental group was 90%, which was significantly higher than that in the control group, and the effective rate was 82%, with statistical difference (P<0.05). There were no obvious adverse reactions in the experimental group and the control group. Conclusion The application of vasoactive drugs under ECG monitoring in the treatment of severe heart failure has better clinical efficacy and higher safety.
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Objective To study the clinical efficacy of low dose thyroxine combined with irbesartan hydrochlorothiazide in the treatment of elderly patients with severe heart failure. Methods 60 cases of elderly patients with severe heart failure who were admitted from January 2015 to December 2016 were selected as the research object in this study. They were randomly divided into control group and experimental group, each group was divided into two groups, each with a total of 30 cases. Patients in the control group were treated with conventional therapy, while the experimental group was treated with low dose thyroxine combined with irbesartan and hydrochlorothiazide. Comparative analysis of clinical efficacy of the experimental group and control group. Results After treatment, the total effective number of patients in the experimental group was 26 cases, the effective rate was 86.7%. The total effective number of patients in the control group was 21 cases, the effective rate was 70.0%. Therefore, the effective rate of the experimental group was significantly higher than that of the control group, with statistical difference (P<0.05). After treatment, the experimental group of patients with left ventricular ejection fraction index, four triiodothyronine and three triiodothyronine levels were significantly higher than those before treatment, the control group of patients with left ventricular ejection fraction were significantly higher than before treatment, with statistical difference (P<0.05). Conclusion Low dose thyroxine combined with irbesartan hydrochlorothiazide in the treatment of elderly patients with severe heart failure has better clinical effect, can improve the therapeutic effect in a certain extent, with further clinical promotion and application significance.intervention in two groups. Results The clinical intervention effect of the observation group was better than that of the control group, the stability of the tumor focus, the degree of pain, the quality of life and other aspects were better than the control group, the difference between the two groups was statistically significant (P<0.05). Conclusion Patients with advanced non-smal cell lung cancer chemotherapy choose psychological intervention compound sophora injection combined treatment effect is remarkable, which can effectively improve the patient's clinical symptoms and quality of life.
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The use of mechanical circulatory support for patients with severe heart failure is on the rist. The poeoperative, intraoperative and postoperative challenges the anaesthesiologists skills. These are discussed in this review