Study On The Intervention Effect Of Different Wetting Methods Of Thirst In Patients During The Awake Period Of Mechanical Ventilation After Cardiopulmonary Bypass

ObjectiveCardiopulmonary bypass(CPB)is a common auxiliary technique in cardiovascular surgery.The objectives of this study include two points:1.To assess the incidence,intensity and distribution characteristics of thirst in patients during the awake period of mechanical ventilation after cardiopulmonary bypass,and to analyze the influencing factors of thirst。2.To compare the effects of different wetting methods on thirst relief,and to provide a basis for the prevention and intervention of thirst in patients with mechanical ventilation after cardiopulmonary bypass。Methods1.The first part was a cross-sectional study.A total of 250 patients undergoing CPB surgery were selected as the research objects by convenience sampling method.VAS and lip,tongue and oral mucosa wetness degree rating scale were used to evaluate patients’thirst and dry mouth.data were collected.To analyze the incidence,intensity,distribution characteristics and influencing factors of thirst in patients with mechanical ventilation after CPB。2,The second part was a randomized controlled trial.A total of 123 patients with thirst during awake period of mechanical ventilation after CPB were selected as the research objects by convenience sampling.They were randomly divided into cotton swab group,normal temperature water spray group and mint water spray group,with 41 cases in each group.The cotton swab group was the control group,and the normal temperature water spray group and mint water spray group were the experimental group.The intervention methods were as follows:when the patients complained of thirst,the VAS score and the wetness degree of lip,tongue and mouth mucosa were evaluated immediately,and then three different interventions were implemented according to the group:the swab group was dipped in normal temperature pure water to wipe the mouth;In the normal temperature water spray group,the elephant trunk spray bottle containing normal temperature pure water was used,and the elephant trunk spray head was extended into the patient’s mouth for spraying.mint water spray group used the elephant trunk spray bottle containing mint water at room temperature,and the elephant trunk spray head was put into the patient’s mouth to spray.The order of intervention in the three groups was as follows:tongue surface,palate,left cheek,right cheek and lip.Each part was repeatedly wiped or sprayed twice.VAS,lip,tongue and oral mucosa wetness score were evaluated again 30 minutes after the intervention.To compare the effects of three moisturizing methods on thirst relief.Results1.Cross-sectional survey resultsThe current situation of thirst in patients with awake mechanical ventilation after CPB:a total of 250 patients were included,and 230 patients had thirst,with a total incidence of thirst of 92%.There were 62 cases with mild thirst,accounting for 27.0%,111 cases with moderate thirst,accounting for 48.2%,and 57 cases with severe thirst,accounting for 24.8%.Binary Logistic regression analysis showed that the duration of tracheal intubation,the duration of intraoperative ascending aorta occlusion,body temperature and diuretics were independent risk factors for thirst in patients undergoing mechanical ventilation after CPB.2.Intervention study results(1)Before intervention,there were no statistically significant differences in the baseline data,VAS score and moist degree of lip,tongue and oral mucosa among the three groups,with comparability(P>0.05).(2)After the intervention,the VAS scores of all the three groups decreased,among which the VAS scores of the cotton swab group decreased from 6.95±1.01 to 4.15± 1.16,the room temperature water spray group decreased from 6.75±0.99 to 3.65±1.29,and the mint water spray group decreased from 6.99±1.68 to 2.92±1.19.The difference of VAS scores between groups after intervention was statistically significant(P<0.05),and the difference of VAS scores within groups before and after intervention was statistically significant(P<0.05).The degree of thirst relief was as follows:mint water spray group>room temperature water spray group>cotton swab group.(3)After the intervention,the lip,tongue and oral mucosa wetness scores of the three groups decreased,among which the cotton swab group decreased from 2.25±0.51 to 1.91 ±0.56,the room temperature water spray group decreased from 2.16±0.55 to 1.67±0.54,and the mint water spray group decreased from 2.14±0.43 to 1.36±0.48.There were statistically significant differences in the wetness degree of lip,tongue and oral mucosa between groups after intervention(P<0.05),and there were statistically significant differences in the wetness degree of lip,tongue and oral mucosa within groups before and after intervention(P<0.05).The improvement of lip,tongue and oral mucosa moisturization was as follows:mint water spray group>room temperature water spray group>cotton swab group.(4)There was no significant difference in the per capita thirst intervention frequency between the cotton swab group and the room temperature water spray group,but they were both more than the mint water spray group,and the difference was statistically significant(P<0.05).There was no significant difference in the duration of thirst relief between the cotton swab group and the room temperature water spray group,but they were both shorter than the mint water spray group,and the difference was statistically significant(P<0.05).(5)No adverse events such as choking and aspiration occurred in the three groups。Conclusion(1)The incidence of thirst is high and the degree of thirst is severe in awake patients with mechanical ventilation after CPB.The duration of tracheal intubation,the duration of ascending aorta occlusion,body temperature and diuretics are independent risk factors for thirst in patients undergoing mechanical ventilation after CPB。(2)The three moisturizing methods can relieve the thirst discomfort of patients in the awake period of mechanical ventilation after CPB.Among them,the effect of mint water spray is better than that of room temperature water spray and cotton swab.mint water spray has the advantages of safety,economy,simple,convenient and easy to obtain,and its clinical application is feasible。...