1例新型冠状病毒肺炎危重型患者行体外膜氧合治疗中的气道管理

Airway management in a critically ill patient with novel coronavirus pneumonia undergoing extracorporeal membrane oxygenation

该文总结了1例新型冠状病毒肺炎危重型患者行体外膜氧合(extracorporeal membrane oxygenation,ECMO)治疗后肺功能改善的护理经验。该患者经口插管辅助通气、抗感染等对症支持治疗后,仍不能脱离呼吸机,并出现持续二氧化碳潴留,气体交换严重受损。予气管切开术和ECMO治疗;同时,采取吸痰护理、雾化吸入治疗、支气管冲洗和侧卧位通气联合体位引流等一系列改善肺功能的护理措施。经过7 d ECMO治疗及护理,患者肺部功能改善,予以撤机。

This article summarizes the nursing experience in a critically ill patient with novel coronavirus pneumonia after extracorporeal membrane oxygenation(ECMO)treatment for lung function improvement.After oral intubation-assisted ventilation,anti-infection,and other symptomatic support treatments,the patient was still unable to breathe without the ventilator.For the sustained carbon dioxide retention and severe gas exchange impairment,he was treated with tracheotomy and ECMO.During the treatment,a series of nursing measures to improve lung function were adopted,such as sputum suction care,atomized inhalation therapy,bronchial irrigation,and lateral ventilation combined with postural drainage.After 7 days of ECMO treatment and nursing,the patient's lung function improved and then he was weaned from the machine.