Effect of competence health cultivation on the prevention and control of inadvertent perioperative hypothermia.

OBJECTIVE To explore the feasibility of health competence cultivation on the prevention and control of Inadvertent Perioperative Hypothermia (IPH). METHODS Patients with expected spinal surgery were divided into group A and group B by the random number method. Group B followed routine IPH management, and health training measures for performance and ability were implemented in Group A. The scores of the health competence questionnaire, the temperature at different times, IPH complications, and hospitalization for the two groups were observed and compared. RESULTS The main evaluation indexes, such as the health competence questionnaire score, temperature fluctuations, and IPH complications, during the perioperative period in group A were significantly better than those in group B (p < 0.05). The indexes of anesthesia, total hospital expenses, and health service satisfaction in group A were also significantly better than those in group B, which shows the advantages of cultivating health capabilities in both doctors and patients. CONCLUSION Through health competence cultivation and feasible health management measures, the medical staff can improve the quality of IPH prevention and management.

[Investigation of relationship between prehospital care for traumatic shock and postoperative acute lung injury/acute respiratory distress syndrome].

OBJECTIVE: To investigate and analyze the correlation and clinical significance of prehospital treatment for traumatic shock and postoperative acute lung injury (ALI)/acute respiratory distress syndrome (ARDS). METHODS: Six hundred cases in the last 10 years were enrolled for double-blind randomized control study. They were divided into 3 groups. Group A consisted of 184 cases who had received combined treatment, group B consisted of 305 cases who had received fluid replacement only and group C consisted of 111 cases with no treatment. The incidence of systemic inflammatory response syndrome (SIRS), ALI and ARDS of each group were analyzed and compared. SIRS was graded at 1 (T0) after admission, 24 (T1), 48 (T2), 96 (T3) and 144 hours (T4) after operation. RESULTS: In 524 cases diagnosis of SIRS was made among 600 patients (87.33%). Among them 73.37% (135/184 cases) were in group A, 91.48% (279/305 cases) belonged to group B and 99.10% (110/111 cases) in group C. The scores of SIRS were notably lower in group A than B and C at each time point (all P<0.01), and they were lower in group B than those in group C (all P<0.01), they recovered at T3 after operation in group A while in group B patients recovered at 144 hours after operation. Eleven patients among 184 (5.98%) were diagnosed to have ALI including 1 case progressed to ARDS and 1 case to MODS and no one died, while in group B 32 cases in 305 (10.49%) had ALI with 7 cases progressed to ARDS and 3 cases to MODS while 3 deaths and in group C 23 among 111 (20.72%) had ALI, and 8 patients progressed to ARDS, 5 cases to MODS and 5 deaths. CONCLUSION: Prehospital treatment is closely related with postoperative ALI, and combined treatment is beneficial in reducing the incidence of postoperative ALI/ARDS.

[Clinical study of the effect of verapamil-procaine compound in prevention and treatment of acute respiratory distress syndrome after high risk operation].

OBJECTIVE: To observe the effect of verapamil-procaine compound (V-P) on prevention and treatment of acute respiratory distress syndrome (ARDS) subsequent to high risk operation. METHODS: Altogether 150 cases of major operations with high risk of ARDS were enrolled for study. They were randomly divided into three groups. V-P group: 5% glucose 500 ml and procaine 1 250 mg and verapamil 10 mg; procaine group: 5% glucose 500 ml and procaine 1 250 mg; control group: only glucose was given. The injection speed of the three groups were the same, and it was kept at 0.5 ml x h(-1) x kg(-1). The dosages of verapamil and procaine in V-P group and procaine group were doubled when the diagnosis of acute lung injury (ALI) or ARDS was confirmed. UT4000F was used in monitoring (non-invasive) blood pressure (BP), electrocardiogram (ECG), pulse oxygen saturation (SpO(2)), respiratory rate, and temperature. Blood routine and arterial blood gases measurements were intermittently performed. Diagnosis of systemic inflammatory response syndrome (SIRS), ALI and ARDS was made respectively according to published diagnostic criteria. SIRS score and acute physiology and chronic health evaluation II (APACHEII) score were performed. RESULTS: Eleven cases in V-P group, 26 in procaine group, and 42 in control group manifested symptoms and signs of SIRS. There were notable differences among groups (all P<0.01). Four patients in V-P group, 7 in procaine group, and 19 in control group were shown to develop ALI. Significant difference was found between control and V-P or procaine group (both P<0.01), but no significant difference was found between procaine group and V-P group. Twelve cases were complicated with ARDS in control group 2 weeks after the operation, and among them 5 died of multiple organ failure. There was significant difference between control group and V-P group or procaine group (both P<0.01). Two patients were complicated with acute renal failure in V-P group, 2 in procaine group, and 5 in control group. CONCLUSION: The V-P can interrupt SIRS to develop ALI, then ARDS and multiple organ dysfunction syndrome(MODS), and thus prevents and cures ARDS.

Effect of competence health cultivation on the prevention and control of inadvertent perioperative hypothermia

SUMMARY OBJECTIVE To explore the feasibility of health competence cultivation on the prevention and control of Inadvertent Perioperative Hypothermia (IPH). METHODS Patients with expected spinal surgery were divided into group A and group B by the random number method. Group B followed routine IPH management, and health training measures for performance and ability were implemented in Group A. The scores of the health competence questionnaire, the temperature at different times, IPH complications, and hospitalization for the two groups were observed and compared. RESULTS The main evaluation indexes, such as the health competence questionnaire score, temperature fluctuations, and IPH complications, during the perioperative period in group A were significantly better than those in group B (p < 0.05). The indexes of anesthesia, total hospital expenses, and health service satisfaction in group A were also significantly better than those in group B, which shows the advantages of cultivating health capabilities in both doctors and patients. CONCLUSION Through health competence cultivation and feasible health management measures, the medical staff can improve the quality of IPH prevention and management.

RESUMO OBJETIVO Explorar a viabilidade do cultivo da competência em saúde na prevenção e controle da hipotermia perioperativa inadvertida (IPH). MÉTODOS Pacientes com cirurgia espinhal marcada foram divididos em dois grupos, A e B, pelo método de números aleatórios. O grupo B foi conduzido com base na gestão rotineira para prevenção de IPH; já no grupo A, foram implementadas medidas de treinamento em competência de saúde. As pontuações do questionário sobre competência em saúde, a temperatura aferida em diferentes momentos, complicações relacionadas à IPH e hospitalização dos dois grupos foram observadas e comparadas. RESULTADOS Os principais índices de avaliação, como a pontuação do questionário sobre competência em saúde, a variação de temperatura e as complicações relacionadas à IPH durante o período perioperatório foram significativamente melhores no grupo A do que no grupo B (p<0,05). Os índices de anestesia, despesas hospitalares totais e satisfação com o serviço de saúde também foram significativamente melhores no grupo A do que no B, o que demonstra as vantagens do cultivo da competência de saúde tanto em médicos como em pacientes. CONCLUSÃO Por meio do cultivo de competências de saúde e de medidas viáveis de gestão da saúde, a equipe médica pode melhorar a qualidade da prevenção e gestão da IPH.