Introduction.
The disease of acute heart failure is very serious for the elderly and can easily endanger the lives of elderly patients, and in the absence of rescue, the disease progresses very quickly, and if the rescue is not timely, it is likely that the patient will lose his life. In order to save the elderly patients from acute heart failure, we now summarize and analyze 80 elderly patients with acute heart failure using mechanical evacuation of trachea in 2010 in our hospital.
Information and measures
(1) General information
Eighty elderly patients with acute heart failure who were admitted to our hospital from January 2010 to June 2012 were analyzed. For these eighty patients, all of them were diagnosed with cardiac function at the tertiary level or higher, and fifty-two of the 80 elderly patients with acute heart failure were male and twenty-eight were female, with an age range between sixty and eighty-five, and an average age of sixty-eight years old or later.
Sixty-one of them had Grade 3 heart function disease and 19 of them had Grade 4. Previously existing diseases: 30 had hypertension, 25 had myocardial infarction, 20 had rheumatic heart disease, and 5 had heart disease. Patients with malignant tumors were excluded, those with chronic kidney disease were excluded, and those with blood disorders were also excluded, as well as those with language impairment and intellectual impairment, and those without the means to communicate. In this study, the cooperation of the patients and the cooperation of their families was required to sign an informed intent.
(2) Measures
When patients with acute heart failure are admitted to the hospital, they are treated according to the general routine. All elderly patients have to be resuscitated by inserting a tube for mechanical tracheal evacuation in the trachea. The mode of mechanical extubation is initially volume control, using the auxiliary mode, followed by positive expiratory pressure, controlling the tidal volume at six to eight milliliters per kilogram, controlling the respiratory rate at sixteen to twenty breaths per minute, controlling the oxygen concentration at 60 to 80 percent, adjusting the oxygen every hour, rising two centimeters at a time, controlling it at 15 Every hour, adjust the oxygen level by increasing it by two centimeters each time, controlling it to less than 15 centimeters, and reducing the oxygen level to less than 60 percent. After the blood analysis, the respiratory parameters are adjusted, and when the disease is in remission, the ventilator mode is changed to intermittent mode, and the machine is gradually withdrawn.
(3) Analysis of indicators
The patients’ reactions to mechanical extubation were observed, and comparisons were made between patients’ reactions, in terms of respiration and cyanosis, to analyze the effect of the treatment, and to analyze the arterial pressure, respiratory rate, heart rate, and other indices related to vital characteristics.
(4) Statistical methods
A software was used to analyze the statistics, and the data were organized scientifically and analyzed in a one-sided manner.
Conclusion
(1) Clinical characteristics
Of the 80 patients suffering from acute heart failure, 69 were treated with mechanical evacuation of the trachea, and the symptoms of dyspnea were reduced, the foam was reduced, and the murmur of the lungs was reduced. 72 of the 80 patients were successfully resuscitated, and 8 died due to organ failure.
(2) Changes in indices of mechanical evacuation tracheal therapy in 80 patients with acute heart failure disease at different periods.
(3) Nursing care
Care for patients during mechanical ventilation: When using mechanical ventilation, the parameters of the ventilator should be set to comply with the principles of high oxygen intake, low tidal volume and high respiratory rate, and then adjust the settings of the ventilator according to the monitoring of the patient. Otherwise, it will cause oxygen toxicity. Acute heart failure can cause rupture of capillaries and increase the amount of fluid exuded, and in order to reduce the amount of fluid exuded, the diffused gas is improved.
Therefore, it is important to start using mechanical evacuation of the airway in order to ensure that the sputum is sealed during aspiration at the right time. The change of pressure will affect the change of fluid during aspiration, which is not easy to control for heart failure. Therefore, two hours after the start of mechanical evacuation, no suctioning should be done as much as possible. If aspiration is needed, special sealed aspiration equipment should be taken, and aspiration tubes and breathing machines should be utilized during aspiration, because the patient’s artificial airway is in a sealed state, so the infection should be controlled by reducing the pressure in order to ensure the stability of blood oxygen and blood flow.
Discussion
Most of the patients suffering from acute heart failure are elderly people because these elderly people have their own heart diseases, plus there are some reasons that can cause cardiovascular diseases, the disease always comes raging and develops very fast, if this kind of patients can not be rescued in time, is to cause great damage to the heart, and it is impossible to repair the heart, so it will cause a high mortality rate.
Mechanical evacuation of the trachea can reduce the action of the breathing machine, bring down the oxygen consumption, increase the pressure in the chest cavity, reduce the amount of blood return, bring down the burden on the heart can be reduced, and the heart function will be greatly improved, with this same, will enhance the internal pressure in the chest, the pressure in the trachea will also be enhanced, bring down the pressure in the wall chamber of the heart, which will also reduce the burden on the heart, and the heart beat will be increased , improving the condition of pulmonary edema.
Positive air pressure will increase the pressure of the air bubbles in the lungs, which will reduce the leakage of fluid from the capillaries in the lungs, and increase the air bubbles and pressure in the lungs, which will facilitate the dispersion of oxygen into the air bubbles in the lungs and improve the synthesis of oxygen and myocardial hypoxia.