Compare The Effect On Sputum Rheology And Humidification By Two Kinds Of Solution To Artificial Airway Patients

Objective: 1. To explore the measurement method of sputum viscosity by rheometer which could provide quantitative index of sputum viscosity, and could be used to judge the humidification effect of different humidification solution. 2. To provide basis for choosing humidification solution by comparing the airway humidification effect of 0.45% Na Cl solution with ambroxol and 0.9% Na Cl solution with ambroxol in patients with artificial airway, and nursing staff could use sputum viscosity measurement method to prevent the sputum of level II forming which could become sputum bolt. 3. To investigate the factors associated with the effect of airway humidification in patients with artificial airway.Methods: 1. 65 sputum specimens were collected in Respiration Department from July 2014 to February 2015. Took 1ml sputum sample twice from each sputum specimen and divided them into two groups. Sputum samples in two groups were diluted by 0.45%Na Cl solution and 0.9%Na Cl solution respectively, and measured by rheometer after adding different proportion of solvent and tyloxapol into them. Analyzed the quantitative index of sputum viscosity by statistical methods.. 2. 40 patients with artificial airway and mechanical ventilation stayed in a tertiary hospital of Tianjin from December 2014 to December 2015 were divided into two groups randomly. The data of social demography, smoking status and APACHEⅡ score were collected. Patients in two groups were humidified by 0.45%Na Cl solution with ambroxol and 0.9%Na Cl solution with ambroxol respectively. Humidification fluids were instilled by trace pump with the speed of 2 ml/h continuously. Data of blood gas analysis, temperature, heart rate, blood pressure, sputum character and viscosity were collected before humidification and after humidification 24 hours, 72 hours. Analyzed the humidification effect of two kinds of liquid and the factors associated with the effect of airway humidification by statistical methods.Results: 1. Sputum viscosity could be measured by rheometer when the volume proportion of sputum, solvent and tyloxapol achieved 10:30:1. 2. The sputum could be measured by rheometer after dealing with both 0.45%Na Cl solution and 0.9%Na Cl solution with tyloxapol. 3. The patients with artificial airway were humidified by two kinds of solution. The humidification effect of 0.45%Na Cl solution with ambroxol was better than 0.9%Na Cl solution with ambroxol. 4. The humidification effect would get better when the time got longer in 72 hour. 5. In this study, there was no correlation between sputum viscosity and blood analysis values, heart rate, blood pressure, temperature, liquid intake and output.Conclusion: If humidification was not reasonable during the artificial airway management process, the thick secretion would become sputum bolt and block the airway, cause hypoxia or asphyxia. In this research, the method to measure objective index of sputum viscosity was explored, and medical staff could adjust humidification plan for the patients with high risk of sputum bolt formation, judge the humidification effect of different humidification solution which would provide basis for selecting humidification solution. In addition, the research came to the conclusion that the humidification effect of 0.45%Na Cl solution with tyloxapol was better than 0.9%Na Cl solution with tyloxapol. Therefore, the medical staff should choose 0.45%Na Cl solution with tyloxapol as humidification fluid to prevent sputum bolt from blocking the airway, and nurse the patients according to factors associated with the effect of airway humidification to improve the quality of artificial airway management.