Preventative Value of Predictive Health Interventions on PICC-Related Thrombosis in Patients with Severe Burns

Abstract

Background Burn mainly refers to the damage caused by high temperature to the skin and mucous membrane tissue. Seriously, it causes damage to the subcutaneous tissue or subcutaneous mucous membrane, which is easy to induce infection and poses a threat to the life safety of patients.For patients with deep burns, surgical removal of damaged skin and mucosal tissue, Postoperative,immediate coverage of surgical wounds,avoid infection due to body fluid and energy loss with related tissue necrosis.The clinical treatment period for critical burn patients is longer and high incidence of postoperative complications.The corresponding nursing intervention while undergoing treatment can help to eliminate the impact of the bad psychological state on the patients, improve the treatment compliance, and reduce the occurrence of complications.

Objective Evaluation of the value of predictive health intervention in preventing thrombosis associated with Peripherally Inserted Central Catheter (PICC) via peripheral vein in critically ill burn patients

Methods Select 90 patients with severe burn treated by PICC infusion from January 2019~ February 2021, Group by reference to intervention methods, with 45 using conventional health intervention (control group) and another 45 using predictive health interventions (observation group). The incidence of pulmonary and wound infection, the incidence of adverse events associated with PICC catheterization and wound healing time were recorded in the two groups. The degree of pain was evaluated by visual simulation (VAS) score, and the differences of platelet, D- dimer (D-D) and hemodynamics were detected in the two groups

Results The incidence of pulmonary infection, PICC associated thrombus and total adverse events  in the observation group was lower，and higher rate of functional recovery,but less wound healing time with control group,which had statistical significance（P<0.05）.Incidence of wound infection, incidence of catheter blockage, incidence of unplanned extubation,the difference was not statistically significant （P>0.05）.Comparison before intervention,The pain score decreased at 7 d、14d、21d (P<0.05), and the observation group was lower than the control group（P<0.05）.Intervention of the 7d、14d two sets all platelet elevation（P<0.05）,but D-D concentration decreases（P<0.05）.Intervention of the 7d、14d two sets was increased of the intrathoracic blood volume index (ITBVI) （P<0.05），but extravascular lung water index（EVLWI）and mean arterial pressure （MAP）the difference was not statistically significant （P>0.05）.

Conclusions Predictive health intervention can reduce the pain degree of critically burned patients, reduce the incidence of adverse events such as infection and PICC-related thrombosis, and promote wound recovery.