The clinical effect of designing and applying protective breathing circuits to prevent ventilator-associated pneumonia
Objective To observe the clinical effect of designing and applying protective breathing circuits to prevent ventila-tor-associated pneumonia.Methods A total of 63 patients requiring mechanical ventilation through endotracheal intubation or tra-cheotomy were selected from our hospital between May 2020 and January 2024.Three different types of respiratory circuits were used for ventilation.Patients were randomly divided into three groups(n=21)according to a random number table method:open respiratory circuit group,semi-closed respiratory circuit group and protective re-spiratory circuit group.The changes in blood oxygen saturation during suctioning or bronchoscopy;the total number of bacterial colonies on the surface of sterile drapes,the back of the operator's hands,the exte-rior of the tracheal tube.and the tip of the bronchfiberscope;the satis-faction of medical staff with the three types of respiratory circuits;and the impact of different respiratory circuits on the duration of mechani-cal ventilation,time to the occurrence and incidence rate of VAP were compared among the three groups.Results In the protective respi-ratory circuit group,there was no significant decrease in SPO2 during suctioning or bronchoscopy,which was significantly better than the other two groups(P＜0.01);Bacterial colonies were almost underdetectable on the surface of sterile drapes,the back of the opera-tor's hands,the exterior of the tracheal tube and the tip end of the bronchfiberscope showing superior protection compared to the other two groups;Gram-positive cocci mainly Staphylococcus aureus and negative bacilli mainly Pseudomonas aeruginosa were detected un-der microscopy in the open and semi-closed respiratory circuit groups.Medical staff had high satisfaction with the convenience and pro-tective effect of the protective respiratory circuit(P＜0.01),with no statistically significant difference in subjective evaluation(P＞0.05);The duration of mechanical ventilation in the protective respiratory circuit group was shorter than those of the open respiratory circuit group and semi-closed respiratory circuit group(P＜0.01).The time of VAP occurrence in the protective respiratory circuit group was longer than those in the open respiratory circuit group and semi-closed respiratory circuit group(P＜0.01);The incidence of VAP in protective respiratory circuit group was lower compared to both the open and semi-closed respiratory circuit groups(P＜0.05).Conclusion The application of a new protective respiratory circuit can effectively reduce the cross-infection of multidrug-resistant bacteria,improve the satisfaction of medical staff,lower the incidence of ventilator-related pneumonia,and benefit patient outcomes.
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