In order to identify the incidence of nosocomial pulmonary infection in surgical critical care patients in our hospital, we studied 800 patients discharged from surgical intensive care unit between May 1992 to Dec. 1994. One hundred and six episodes of pulmonary infection were found in 96 cases, in which 20 cases had been re-infected. The infection rate was 12.0%. The age of patients, APACHE- Ⅱ score and duration in ICU were closely related to the incidence of pulmonary infection. Tracheal intubation, tracheotomy and mechanical ventilation were the predisposing factors. The prevalent pathogens were pseudomonas aeruginosa, acinetobacter, staphylococcus aureus and candida albicans. 54.7% of cases were infected with more than one pathogens, and 36.8% of cases had fungal infection. The prevention and treatment are also discussed.
Forty critical patients with respiratory failure in the intensive care unit were randomly divided into two groups,Group A with administration of parenteral nutritino(PN) and Group B,no parenteral nutrition given.Blood gas analysis and respiratory monitoring showed that the respiratory rate,pH、PaO2、PaCO2 and HCO3- had no marked difference between the two groups.But in Group A there was a slight decrease of Pao2/FiO2 and a marked increase of A-aDO2 and the pulmonary shunt.This study indicates that the content of fat emulsion and hydrocarbon in PN may be the main factor that affects the respiratory function.
【摘要】 目的 探討甲型H1N1流感危重癥患者的搶救療效。 方法 2009年10月－2010年1月，對我院ICU收治5例甲型H1N1流感危重癥患者采用集束化治療方案進行救治，并就患者的器官功能變化進行評價。 結果 5例患者平均住院天數為（11.8±5.59）d，4 例存活，1例死亡。存活患者在治療過程中急性生理和既往健康 （APACHE）Ⅱ、多器官功能障礙綜合征評分（MODS）、全身性感染相關的器官衰竭評分 （SOFA）總體呈逐漸下降趨勢。死亡者APACHEⅡ、SOFA評分均呈逐漸升高趨勢。 結論 對甲型H1N1流感危重癥患者采取集束化救治療效良好。【Abstract】 Objective To explore the effect of bundle therapy on severe patients with influenza A (H1N1). Methods Bundle therapy were used in 5 severe patients with influenza A from October 2009 to January 2010. The patients’ organ dysfunction were observed for. Results The average in-hospital duration was (11.80±5.59) days. Four patients survived and one died with the survival ratio of 80%. Acute physiology and chronic health evaluation (APACHE) II score, Multiple organ dysfunction syndrome (MODS) score and sepsis-related organ failure assessment (SOFA) score gradually decreased in 4 survived patients, while gradually increased in the died patient. Conclusion Bundle therapy is effective on patients with severe influenza A.
