1例静脉-静脉体外膜肺氧合联合连续性肾脏替代治疗救治硝酸烟雾中毒患者的护理

Nursing care of a patient with inhalation of nitric acid fumes treated by veno-venous extracorporeal membrane oxygenation combined with continuous renal replacement therapy

总结1例静脉-静脉体外膜肺氧合联合连续性肾脏替代治疗救治硝酸烟雾中毒患者的护理。护理要点:密切关注呼吸功能变化,严格实施肺保护性通气策略;及时清除气道分泌物,保障有效通气;控制原发感染,预防继发感染;优化容量管理,促进组织灌注的恢复和维持;预防血栓形成,降低出血风险;预防及处理输血反应,落实上消化道出血的术后管理。经过精心护理,患者情况稳定并出院。出院6个月随访,患者预后良好,无肺部并发症。

To summarize the nursing experience of a patient with inhalation of nitric acid fumes treated by veno-venous extracorporeal membrane oxygenation combined with continuous renal replacement therapy.The key points of nursing include:to pay close attention to the changes of respiratory function,to strictly implement lung protective ventilation strategy;to timely remove airway secretions to ensure effective respiratory;to prevent and control infection;to optimize fluid management to facilitate tissue perfusion;to prevent thrombosis and reduce the risk of bleeding;prevention and treatment of blood transfusion reaction,the postoperative nursing of complicated with upper gastrointestinal bleeding.After active treatment and careful nursing,the patient was discharged from the hospital in a stable condition.After 6 months of follow-up after discharge,the patient recovered well with no pulmonary complications.