Design and Patients
The project was approved by the hospital’s ethical committee. All the data was collected from the record of daily nursing work after carrying out a proper screening. The information of the subjects that admitted in this study was patients who lived in the neurosurgery department with severe traumatic brain injury that need performing tracheotomy in our hospital, from January 2016 to December 2018. The patients were divided into oxygen spraying group (group A), heat and moisture exchanger (HME) (group B), and the heating and humidification group (group C) according to the humidification method the nurse chose. We excluded the patients that don’t satisfy our demands. Inclusion criteria: GCS score 8 points; No basic lung disease; No mechanical ventilation is required. The primary morbidity is traumatic brain injury or cerebral hemorrhage. Exclusion standard: The bleeding amount is 5 ml on the day after tracheotomy; Mechanical ventilation is still required within 3 days after tracheotomy; In-Hospital duration 3 days; Death or automatic discharge; Pulmonary infection is already present. The severity was divided into two groups according to Glasgow score (GCS)12, 3-5 points group and 6-8 points group. According to the in-hospital time, into and 50 patients that nursed with each method were admitted. The patients were supplied with low speed of oxygen at the first 7 days, and the patients with spontaneous respiratory were stopped oxygen supplement after they passed 7 days’ acute injury stage.