Emergency treatment and nursing of children with severe pneumonia complicated by heart failure and respiratory failure: 10 case reports

Li, Wanli; An, Xinjiang; Fu, Mingyu; Li, Chunli

Commonly used drugs included: 20,000 units of gentamicin, 2-3 mg of α-chymotrypsin, 1-2 mg of dexamethasone, and 20 ml of saline. The dual role of the aforementioned ultrasonic aerosol inhalation was useful to reinforce treatment of children with severe pneumonia. According to the disease, aerosol inhalation was conducted every 4 or 6 h, with sputum suction ensuing, which produced a good suction effect for children patients with many sticky respiratory secretions. It should be noted that if patients had excessive sputum, the sputum suction was also carried out once prior to using ultrasound aerosol inhalation therapy, followed by thorough sputum suction. In the whole process of aerosol inhalation, providing oxygen inhalation or enhancing oxygen concentration effectively prevented the occurrence of hypoxemia (31) . iii) Hypocalcemia may produce laryngospasm and tongue tenesmus, which causes obstruction and sudden suffocation. First, the child patient's tongue tip was pulled outside the mouth, and then artificial respiration was conducted, with most patients being able to relieve themselves spontaneously. Pressurized oxygen was given, endotracheal intubation was carried out if necessary and calcium was replenished immediately. iv) When nasal obstruction caused breathing difficulties, 1% ephedrine drops were used after clearing away nasal secretions with a cotton swab, to maintain the airway patency. v) The diet of children with severe pneumonia was affected due to high fever, vomiting, diarrhea and other factors. When children patients were unable to eat, it was appropriate to supplement water, electrolytes, vitamins, and give them high-calorie, high protein, digestible food, that was eaten in small amounts but frequently, to prevent satiety from interfering with respiratory function. vi) Previous findings showed that, ambroxol and low-dose heparin coupled with aerosol inhalation significantly shortened the time of the disappearance of all the clinical signs and improved overall efficiency of the clinical treatment (32, 33) . There was no bleeding and other adverse reactions involved in the clinical treatment process, which had advantages such as easy administration, safe use, inexpensiveness, a significant effect, and less adverse effects in the treatment of children with severe pneumonia, and was thus worthy of wider application.