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Objective: Due to severe brain disease in patients admitted to the ICU for a long time, high cost, during the ICU stay extremely complicated ventilator-associated pneumonia, and treatment is difficult, the prognosis is poor. To explore more effective treatment of ventilator-associated pneumonia (VAP) method, we designed the treatment of VAP Bundle for intensive care unit patients with severe brain disease ventilator-associated pneumonia prognostic values. Methods: 687 cases of patients admitted to the ICU with severe cerebral disease, the patient's family informed consent, in the absence of sedation given under APACHE Ⅱ quantify Fufen, according to diagnostic criteria for VAP included pilot study for age lt; 18 years old, and VAP Non-brain disease, the clinical diagnosis of VAP, 20 cases were treated with mechanical ventilation prospective randomized - controlled trial method, the brain disease in patients with ventilator-associated pneumonia were randomly divided into conventional treatment (control group, 9 cases) and Bundle treatment group (11 cases a test group between the two groups of the same basic treatment program, Bundle treatment group increased: (a) rational use of antibiotics, highly suspicious bacterial infection combined with the spectrum of ICU step-down therapy treatment to be given to bacterial culture results After the targeted treatment options sensitive antibiotics. (2) daily application of fiberoptic bronchoscopy visualization suction, application of saline lavage implementation airway to keep the airway clean; (3) every 6 hours alternating application of 2% chlorine has fixed with 4% sodium bicarbonate solution, clean the oropharynx, each dose is about 50ml, cleaning parts, including teeth, gums, oral mucosa, tongue, and throat rinse time gt; 1 分钟; (4) head up 30-45 °, to prevent hypostatic pneumonia, every six hours OK stand snap back, vibration machine vibration sputum expectoration, vibration frequency of 20-25 beats / min, the time is not less than 20 minutes; (5) Application thymosin-α and enhance immunity. observed in patients admitted to the ICU ICU stay time and costs. observation period, in strict accordance with a predetermined program implementation Bundle therapy treatment. Statistical analysis was performed using measurement data were expressed as mean ± standard deviation (X ± S) said that the two groups used to compare between two independent samples t-test to compare the rate between the two groups using Fisher's exact test P-value calculated directly. significance level of α = 0.05. ICU stay in a small sample of data Kaplan-Meier survival analysis Results: The experimental group admitted to the ICU time 13.902 ± 2.702 (CI :8.605-19 .198) days in the control group, ICU admission time 17.194 ± 2.228 (CI :12.827-21 .562) days (2) the experimental group during the ICU stay cost test Group: 5.8281 ± 2.908, control group: 7.0391 ± 1.416 (P = 0.041). Conclusions: Bundle treatment did not affect the improvement of cerebral disease patients with VAP and mortality rates, but it can reduce severe brain disease ICU stay, lower check ICU costs, Bundle Taiwan therapy regimen is worthy of trust.
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