ĐÁNH GIÁ TÁC DỤNG CỦA PHƯƠNG PHÁP NỘI SOI PHẾ QUẢN KẾT HỢP KHÍ DUNG HEPARIN VÀ N-ACETYLCYSTEIN TRÊN MỘT SỐ CHỈ SỐ HÔ HẤP VÀ KHÍ MÁU Ở BỆNH NHÂN BỎNG HÔ HẤP

Abstract

Objective: Evaluate the effect of bronchoscopy combined with nebulizer Heparin and N-Acetylcysteine ​​in the treatment of inhalation injury. Subjects: Prospective, interventional study on 76 adult burn patients with inhalation injury, hospitalized within 48 hours of burn injury. Patients treated at the Intensive Care Unit - Le Huu Trac National Burn Hospital from November 2021 to February 2024. The patients were randomly divided into 2 groups: group 1 (control group) was treated according to the conventional regimen, group 2 (intervention group) was treated according to the regimen combined with bronchoscopy and nebulizer Heparin and N-Acetylcysteine. Results: The patients studied were severe burn patients with total burn surface area of ​​over 60% and deep burn area of ​​nearly 40%. There were no differences in epidemiological characteristics and arterial blood gas indices at admission between the two study groups. The rate of lung injury on X-ray images was in 31 patients (40.8%) and was equivalent in the two groups of patients studied (p>0.05). Group 2 respiratory indexes include the PaO2/FiO2 ratio increasing and averaging over 300 mmHg on day 7, Compliance increasing on average over 40 ml/cmH2O from day 4 and reaching 50 ml/cmH2O on day 7, PaCO2 concentration on day 5 increased by 48 mmHg on the remaining days lower than 45 mmHg, Pplateau decreased by an average of 1,814 cmH2O. The changes in respiratory indices of the two groups of patients studied had a statistically significant difference (p<0.05). Conclusion: The treatment of inhalation injury by bronchoscopy combined with nebulized Heparin and N-Acetylcysteine ​​has not changed the rate of pneumonia compared to conventional treatment but has positively improved the respiratory index of inhalation injury patient