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10 January 2024, Volume 5 Issue 1 Previous Issue    Next Issue

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Start a new path with original heart，keep being outstanding with the mission WU Xinjuan 2024, 5 (1):  5-6.  Abstract ( 88 )   Save Related Articles | Metrics

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Take the road of sustainable development of the journal with the orien- tation of discipline progress JIANG Xiaoying 2024, 5 (1):  7-9.  Abstract ( 73 )   Save Related Articles | Metrics

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The levels of psychological resilience and influencing factors path analysis in ICU patients with physical restrain CHEN Qiaoling, LIN Ruyu, ZHU Xuanjing, BIE Yuanyuan, ZHAO Huiling 2024, 5 (1):  10-15.  doi: 10.3761/j.issn.2096-7446.2024.01.001 Abstract ( 231 )   Save Objective To describe the level of psychological resilience in ICU physically restrained patients and to explore the influencing factors. Methods A general information questionnaire，Connor-Davidson Resilience Scale， Social Support Rating Scale，General Self-Efficacy Scale，Medical Coping Modes Questionnaire，and the Chinese short version of the Eysenck Personality Questionnaire were used to investigate 301 physically restrained patients admit- ted to the Department of Intensive Care Medicine of a tertiary class A hospital in Fujian Province from December 2021 to December 2022. Structural equation modelling was used to conduct the path analyses for the various influ- encing factors. Results Total psychological resilience score of ICU physically restrained patients was （53.17 ± 17.41），self-efficacy score was （25.16±7.96），social support score was （38.93±15.12），medical coping total score was （44.15±15.21），and Eysenck's personality total score was （23.68±2.98）. The total psychological resilience score of ICU physically restrained patients was positively correlated with the total social support score （r=0.585，P<0.001）， positively correlated with the total self-efficacy score （r=0.545，P<0.01），positively correlated with the confrontation dimension of the medical coping styles （r=0.602，P<0.01），and negatively correlated with the yielding and avoidance dimensions （r=-0.567，P<0.01；r=-0.627，P<0.01），positively correlated with the introversion and extroversion dimen- sions of personality traits（r=0.326，P<0.01），and negatively correlated with neuroticism，psychoticism，and dissimulation scores （r=-0.395，P<0.01；r=-0.338，P<0.01；r=-0.362，P<0.01）. The model was well-fitted，social support had direct and indirect effects on psychological resilience（r=0.546，P<0.001；r=0.267，P<0.001），self-efficacy had a direct effect onpsychological resilience （ r=0.218，P<0.001）. Confrontation coping style had a direct positive effect on psychological resilience（ r=0.415，P<0.001），avoidance coping style had a direct negative effect（ r=-0.216，P=0.007） and resignation coping style had a direct negative effect on psychological resilience （ r=-0.431，P<0.001）. Personality traits had a significant negative effect on psychological resilience（r=-0.606，P<0.001）。 Conclusion The overall level of psychologi- cal resilience of ICU physical restraint patients is low. Social support，self-efficacy，coping styles，and personality traits are important influencing factors on the psychological resilience of ICU physical restraint patients. Improving the level of their psychological resilience can be approached from these four factors. Related Articles | Metrics

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Application of progressive muscle relaxation training in patients with awake prone ventilation ZHENG Yao, SHI Zeya, SONG Ying 2024, 5 (1):  16-21.  doi: 10.3761/j.issn.2096-7446.2024.01.002 Abstract ( 163 )   Save Objective To investigate the effect of progressive muscle relaxation training in awake prone ventilation in patients with acute respiratory distress syndrome(ARDS). Methods The quasi-experiment research method was used. 45 ARDS patients in a tertiary hospital in Hunan Province from May to July 2023 were selected as the experimental group,and the progressive muscle relaxation training program was used before prone ventilation. 45 ARDS patients from December 2022 to February 2023 were selected as the control group,and traditional prone- position ventilation was used. The maximum duration of a single daily treatment and the total duration of treatment in the first 3 days of prone position ventilation,tolerance,and the effect of treatment were compared between the two groups. Results The maximum duration of a single daily treatment [(3.68±0.71) h] of experimental group in the third day of awake prone ventilation was higher than that of control group [(2.50 ±0.67) h],and the total duration of treatment [(36.72±0.56) h] in the first 3 days of experimental group was higher than that of control group [(23.25±1.76) h] (P<0.001). The tolerance index (Visual Analogue Score-VAS) [(2.83 ±1.74) points] of experimental group was lower than that of control group[(6.17±1.11) points] on day 3 of treatment(P<0.001). The blood oxygen partial pressure and oxygenation index of experimental group were better than those of control group4 h after prone position treatment(P<0.001). Conclusion Progressive muscle relaxation training can effectively prolong the ventilation treatment time of awake prone position in ARDS patients,improve tolerance,and thus improve the therapeutic effect. Related Articles | Metrics

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Construction of a program for prone position ventilation in cardiovascular critical patients YAN Lin, LIU Zhouzhou, WU Rong, LI Ru, JI Shiming, ZHANG Yanjuan, PANG Ran, YANG Yang, ZHANG Xiangyu, LI Yonggang, GAO Chuan, ZHANG Chen 2024, 5 (1):  22-28.  doi: 10.3761/j.issn.2096-7446.2024.01.003 Abstract ( 241 )   Save Objective This study aims to construct a program for prone position ventilation in cardiovascular critical patients，and to provide scientific references for the safe and effective implementation of prone ventilation in these patients. Methods The study group searched domestic and international databases，guideline websites and professional websites to retrieve relevant literature，and then selected clinical experts for semi-structured interviews， the first draft of the program was formed based on the literature analysis and the interviews. Delphi technique method was used to modify，add or delete items，and then the final draft of the program was formed. Results 2 rounds of Delphi consultation were conducted among 15 experts，and the effective recovery rate of the questionnaire was 100%. The expert authority coefficient was 0.855，and the Kendall harmony coefficient after the second round of consultation was 0.236 （P <0.001）. The final draft of the program contained 25 items，the mean value of importance assignment of items was 4.27 ~5.00. Conclusion The program constructed in this study is scientific， specific and reliable，with reference significance for clinical implementation. Related Articles | Metrics

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Bedside ultrasound exploration of subglottic secretion in patients with tracheal intubation and retention risk factors analysis GAI Yubiao, XIN Chen, LIN Hui, GUO Xiaojing, ZHANG Yuchen, YAO Bo 2024, 5 (1):  28-32.  doi: 10.3761/j.issn.2096-7446.2024.01.004 Abstract ( 152 )   Save Objective To explore the risk factors of subglottic secretion retention in patients with tracheal intubation by bedside ultrasound. Methods We selected 200 critically ill patients with tracheal intubation in ICU from January to June 2023. The ultrasound was used to distinguish the patients with retained subglottic secretions or not. The influencing factors of subglottic secretion retention in patients with tracheal intubation were analyzed by univariate factor analysis，and the high-risk factors of subglottic secretion retention in patients with tracheal intubation were analyzed by binary Logistic regression. Results Among the 200 patients with tracheal intubation， 106 patients had subglottic secretions retention，accounting for 53%. Univariate statistical analysis showed that age， intubation days，intubation material，the proportion of tracheal intubation with subglottic suction，indwelling gastrictube，8 mm tracheal intubation and the disease type proportion of patients without general anesthesia operation were the influencing factors of subglottic secretion retention. Logistic regression analysis showed that only age （OR=0.699） and indwelling gastric tube （OR=2.499） were the risk factors of subglottic secretion retention. Conclusion Bedside ultrasound has certain application value in the exploration of subglottic secretion in patients with tracheal intubation，age and indwelling gastric tube are independent risk factors for subglottic secretion retention，which provided theoretical reference for clinical nurses to strengthen airway management. Related Articles | Metrics

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Summary of the best evidences for the management of the peri-extubation period for ICU adult patients with tracheal intubation ZHOU Hongfang, LAN Xuhong, JIA Donghui, WANG Qian, WANG Hengyang, ZHANG Ying, ZHANG Zhigang 2024, 5 (1):  33-39.  doi: 10.3761/j.issn.2096-7446.2024.01.005 Abstract ( 304 )   Save Objective To search and summarize the best evidences for the management of the peri-extubation period for ICU adult patients with tracheal intubation，which will provide practical reference for clinical medical staff. Methods We systematically searched UpToDate，BMJ Best Practice，National Institute for Health and Clinical Excellence，Scottish Intercollegiate Guidelines Network，Guidelines International Network，US National Guideline Clearinghouse，Registered Nurses Association of Ontario，American Society of Intensive Care Medicine，European Society of Intensive，Medlive guide，Cochrane Library，PubMed，Embase，CINAHL，SinoMed，CNKI，VIP database， Wangfang database about Clinical decisions，guidelines，best evidences，systematic reviews，expert consensus related to the extubation period for adult patients with tracheal intubation，the retrieval period was from the date of inception to March，2023. Two reviewers independently screened the literatures and extracted data. Results 16 articles were included，with 5 clinical decisions，10 guidelines，and a systematic review. A total of 28 best evidences were collected from 6 subthemes and 3 themes，including before extubation (pre-extubation assessment，planning，readiness testing)，extubation and after extubation (monitoring，special populations，re-eating). Conclusion The best evidences summarized in this study can provide reference for medical staff to manage patients with high-risk failure of extubation and standardize the nursing during the extubation period. In clinical practice，it is necessary to combine the best evidences with specific situations，select and apply the evidences to improve patient prognosis and nursing quality. Related Articles | Metrics

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Nursing care of prone position ventilation under the support of extracorporeal membrane oxygenation in patients with primary graft dysfunction after lung transplantation FENG Shiping, WANG Haixiang, WANG Dapeng, PU Minhua 2024, 5 (1):  40-43.  doi: 10.3761/j.issn.2096-7446.2024.01.006 Abstract ( 81 )   Save The nursing experience of prone position ventilation supported by extracor- poreal membrane oxygenation （ECMO） in 8 patients with severe primary graft dysfunction （PGD） after lung transplantation. We adopted precise fluid management，enhanced airway management during pulmonary edema， comprehensive measures based on patient safety and early pulmonary rehabilitation training to deal with the patient’s fluid control，airway maintenance，prone position，pulmonary rehabilitation and other issues. 7 patients were eventually transferred to the transplantation ward successfully，while one patient died of multiple organ failure. Related Articles | Metrics

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Nursing care of six lung transplantation patients with hybrid extracorporeal mem- brane oxygenation ZENG Fei, LAN Meijuan, ZHENG Yeping, LIANG Jiangshuyuan, GU peipei 2024, 5 (1):  43-46.  doi: 10.3761/j.issn.2096-7446.2024.01.007 Abstract ( 92 )   Save To summarize the nursing experience of 6 cases of lung transplantation patients with hybrid extracorporeal membrane oxygenation （ECMO）. In view of the complicated procedure of turn flow，difficulty of management and multiple safety risks in this group of patients with hybrid ECMO，the following targeted nursing measures were taken，including establishing a professional working mechanism for highly effective cooperation of doctors and nurses，precise flow regulation to ensure effective cardiopulmonary support，clear pipeline management to ensure patient safety，monitor of neurological symptoms through multiple channels and close monitoring of complications. With careful care，all patients had no related complications during ECMO transfer，and the machine was successfully removed. Related Articles | Metrics

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Nursing care of secondary glottis imperfection after weaning in a ventilated patient with Lemierre syndrome ZHOU Feifei, GAO Chunhua, LIN Yan 2024, 5 (1):  47-50.  doi: 10.3761/j.issn.2096-7446.2024.01.008 Abstract ( 82 )   Save To summarize the nursing experience of weaning in a ventilated patient with Lemierre syndrome and secondary glottis imperfection. In view of the difficulty of weaning and the high risk of re- intubation，we adopted respiratory support in acute phase，risk assessment before extubation and multi-disciplinary extubation strategy，post-extubation observation and emergency treatment，early warning assessment to balance bleeding and thrombosis，active infection control to prevent cross infection，staged rehabilitation training，goal-oriented nutritional support and positive psychological support and other measures. After 25 days of active treatment and nursing，the patient’s condition improved，transferred to the rehabilitation hospital for continue treatment. The patients were followed up for 3 months and his life returned to normal. Related Articles | Metrics

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Emergency nursing of thrombus detachment in the lower limbs in a patient with acute pulmonary embolism TONG Pei, WANG Fang, SU Hua, DU Jianli 2024, 5 (1):  51-54.  doi: 10.3761/j.issn.2096-7446.2024.01.009 Abstract ( 268 )   Save To summarize the emergency nursing care for a patient with pulmonary embolism due to subcutaneous bleeding，who has insufficient anticoagulation and thrombus detachment in the lower extremities leading to worsening acute pulmonary embolism. Nursing points：dynamic assessment of patients’ pulmonary embolism risk stratification and adoption of personalized nursing measures，dynamic adjustment of anticoagulant drug dosage and close observation of bleeding，strengthening of observation and nursing care during inadequate anticoagulation to prevent dislodgement of lower limb thrombus. With the participation of the rapid response team，the patient was transferred to the intensive care unit for further treatment within half an hour. After active resuscitation，the patient was transferred back to the Department of Respiratory Medicine nine days later，and he was improved and discharged. Related Articles | Metrics

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Emergency nursing care of a patient with tetrachloroethylene poisoning treated by combining traditional Chinese and Western medicine to promote the excretion of poison LIN Zhenhua, WEI Jianhua, ZOU Jitao 2024, 5 (1):  55-57.  doi: 10.3761/j.issn.2096-7446.2024.01.010 Abstract ( 120 )   Save To summarize the emergency nursing experience of a patient with multiple organ dysfunction caused by oral tetrachloroethylene poisoning. Targeted nursing measures should be taken to address the multi-channel absorption of toxins and the rapid progression of the disease，including the need of rapid and thorough removal of toxins while protecting visceral functions， we adopted a sequential detoxification strategy combined digestive tract- respiratory tract-skin-visceral system，high tidal volume mechanical ventilation strategy to promote detoxification， dynamic evaluation of lung ultrasound to prevent barotrauma，and visualization of traditional Chinese medicine gastric lavage during mechanical ventilation to prevent aspiration. After comprehensive and efficient first aid and nursing through the integration of traditional Chinese and Western medicine，the patient’s condition improved and was discharged 6 days after admission. There were no abnormalities in the one-month follow-up after discharge. Related Articles | Metrics

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Nursing care of inferior vena cava thrombosis complicated after left ventricular assist device implantation in a patient with acute myocardial infarction ZHANG Shuai, CHEN Juanhong, YAO Huipin 2024, 5 (1):  58-61.  doi: 10.3761/j.issn.2096-7446.2024.01.011 Abstract ( 139 )   Save To summarize the nursing experience of a patient with inferior vena cava thrombosis complicated after left ventricular assist device implantation. For patients with postoperative inferior vena cava thrombosis，changes in consciousness，and complications of arrhythmia，anticoagulation management and bleeding prevention should be done well，and early countermeasures should be taken by identifying arrhythmia. We did a good job in infection control， and provided early rehabilitation exercises and other measures for the disease progression. After treatment and nursing，he was transferred from the ICU to the general ward 63 days later. Related Articles | Metrics

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Nursing of a patient with severe pneumonia complicated by severe rhabdomyolysis and multiple organ failure XIE Pailing, YUAN Shuaishuai, LIU Fengqing, LIAN Subing 2024, 5 (1):  61-64.  doi: 10.3761/j.issn.2096-7446.2024.01.012 Abstract ( 129 )   Save To summarize the nursing experience of one patient with severe rhabdomyolysis and multiple organ failure caused by a novel coronavirus infection. Due to the acute stage of COVID-19 leading to dyspnea，multiple organ failure，activity intolerance，ICU syndrome，and other nursing problems，targeted etiological treatment，continuous renal replacement therapy（CRRT） combined with prone ventilation strategy，early rehabilitation，psychological support， and other measures were adopted. After his condition improved on the 60th day，the patient was transferred to the respiratory department for further treatment and was discharged on the 78th day of admission. Related Articles | Metrics

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Risk management of pulmonary alveolar proteinosis patients undergoing whole lung lavage XU Xiaoyan, LÜ Zhanghong, SUN Saijun 2024, 5 (1):  64-67.  doi: 10.3761/j.issn.2096-7446.2024.01.013 Abstract ( 77 )   Save To summarize nursing experience of risk management for 12 patients with pulmonary alveolar proteinosis undergoing whole lung lavage based on Hall’s three-dimensional model. According to the particularity of the disease and the multiple risks of whole lung lavage，the risk of patients was graded and controlled，and early warning was given. The Hall three-dimensional model was introduced to take the perioperative period of whole lung lavage as the axis，and the professional knowledge and logic thinking ability were used to systematically investigate and deal with risks and hidden dangers，so as to improve the safety nursing efficiency. The patients were hospitalized for 4-29 days and discharged after symptoms improved. Related Articles | Metrics

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Status quo and influencing factors analysis of knowledge，attitude，behavior of hypoactive delirium among ICU nurses YU Mengting, MI Jie, ZHANG Wanzhu 2024, 5 (1):  68-73.  doi: 10.3761/j.issn.2096-7446.2024.01.014 Abstract ( 103 )   Save Objective To investigate the knowledge，attitude and behavior of ICU nurses on hypoactive delirium and analyze its influencing factors. Methods A total of 780 ICU nurses were selected from 38 districts and counties in Chongqing by convenience sampling method，and a cross-sectional survey was conducted using the questionnaire of hypoactive delirium knowledge，attitude and behavior of ICU nurses. Results ICU nurses had poor knowledge of hypoactive delirium，and were active in early identification and nursing of patients with hypoactive delirium，and it was needed to improve early treatment and screening of hypoactive delirium. Through multiple linear regression analysis，different years of working experience in ICU（t=-3.453，P=0.001），caring for patients with delirium（t=2.795，P=0.005），attending training on ICU hypoactive delirium（t=3.712，P<0.001） had impact on the knowledge score of ICU nurses，different professional titles（t=2.941，P=0.003） had impact on the attitude score of ICU nurses，attending training on ICU hypoactive delirium（t=6.458，P<0.001）had an impact on the behavior score of ICU nurses. Conclusion ICU nurses in different level of hospitals have poor knowledge of hypoactive delirium，it is urgent to improve regular delirium screening and early management of patients. It is necessary to develop standardized assessment and nursing programs for hypoactive delirium and improve the nursing quality of hypoactive delirium. Related Articles | Metrics

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Development of knowledge，attitude and practice questionnaire about intensive care unit nurses’ target temperature management for patients with severe traumatic brain injury and the reliability and validity test ZHU Wei, HAO Yaru, MU Wenjing, REN Xuanlin, WU Hui, GUO Yue, FAN Luo 2024, 5 (1):  74-79.  doi: 10.3761/j.issn.2096-7446.2024.01.015 Abstract ( 90 )   Save Objective To develop a knowledge，attitude and practice（KAP） questionnaire about intensive care unit （ICU） nurses’ target temperature management（TTM） for patients with severe traumatic brain injury（STBI），and to test its reliability and validity. Methods Using the theory of KAP as the framework，a pool of questionnaire items was initially constructed through literature analysis and group discussion，and then the first draft of the questionnaire was determined by Delphi method and pre-survey. 240 ICU nurses from four hospitals in Gansu Province were selected for the questionnaire survey using convenience sampling method to test the reliability and validity of the questionnaire in October 2022. Results The KAP questionnaire about ICU nurses’ TTM for patients with STBI contained 3 dimensions with 32 items. The overall content validity index of the questionnaire was 0.955，and the content validity index of the items was 0.800~1.000. Exploratory factor analysis extracted 4 main factors with a cumulative variance contribution rate of 58.889% . The overall Cronbach’s α coefficient of the questionnaire was 0.862，the retest reliability coefficient was 0.890. The Cronbach’s α coefficients of the dimensions of knowledge，attitude，and practice were 0.713，0.925，and 0.924 respectively，and the retest reliability coefficients was 0.801，0.943 and 0.950 respectively. Conclusion The KAP questionnaire about ICU nurses’ TTM for patients with STBI has good reliability and validity and can be used as an assessment tool to measure ICU nurses’ KAP of TTM for patients with STBI. Related Articles | Metrics

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Summary of the best evidence for perioperative blood pressure management in carotid artery stenting patients YANG Hongyan, LAN Meijuan, WEI Hui, LIU Miaomiao, YANG Ting, YANG Linghong 2024, 5 (1):  80-85.  doi: 10.3761/j.issn.2096-7446.2024.01.016 Abstract ( 121 )   Save Objective To search，evaluate and summarize the best evidence of perioperative blood pressure management in carotid artery stenting （CAS） patients at home and abroad，in order to provide reference for clinical practice. Methods We retrieved relevant literature on perioperative blood pressure management of CAS patients in domestic and foreign databases based on the "6S" pyramid model system. The literature types included clinical decision-making，guideline，expert consensus，and systematic review. The retrieval time was from the establishment of the database to April 18，2023. Two researchers independently evaluated the quality of the literature and extracted evidence. Results A total of 7 literature were included，including 2 clinical decisions，3 guidelines and 2 expert consensus papers. Twenty-three pieces of evidence were summarized from four aspects including blood pressure management principles，preoperative blood pressure management，intraoperative blood pressure management，and postoperative blood pressure management. Conclusion This study summarizes the best evidence for perioperative blood pressure management in CAS patients. The overall quality of the evidence is high，and it is recommended that medical staff develop appropriate personalized blood pressure management plans for different groups of people to better promote patient blood pressure management. Related Articles | Metrics

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Summary of the best evidence for prevention of deep vein thrombosis in patients with aneurysmal subarachnoid hemorrhage XIE Wenguang, ZHANG Chao, LIU Xiaoyu, SHU Yue, YANG Xinchen, DENG Yulu 2024, 5 (1):  85-91.  doi: 10.3761/j.issn.2096-7446.2024.01.017 Abstract ( 118 )   Save Objective To retrieve，evaluate and summarize the best evidence for the prevention of deep veinthrombosis in patients with aneurysmal subarachnoid hemorrhage. Methods Guidelines，evidence summaries，expert consensus，systematic reviews and clinical decisions on the prevention of deep vein thrombosis in patients with aneurysmal subarachnoid hemorrhage were retrieved from evidence-based databases，comprehensive databases and professional association websites. The search period was from January 2011 to March 2023. Four researchers independently evaluated the quality of the literature，and two researchers extracted and summarized the evidence that met the quality standards. Results A total of 14 articles were included，including 2 clinical decisions，5 guidelines，2 systematic reviews，and 5 expert consensuses. Finally，31 pieces of evidence were summarized from 7 aspects，including risk factor assessment，basic prevention，mechanical prevention，drug prevention，prevention of neurological complications，informed consent，and first aid for sudden aneurysm rupture. Conclusion The best evidence for prevention of deep vein thrombosis in patients with aneurysmal subarachnoid hemorrhage can provide evidence-based basis for clinical medical staff. It is recommended that medical staff adopt the evidence according to clinical practice to reduce the incidence of deep vein thrombosis in patients with aneurysmal subarachnoid hemorrhage. Related Articles | Metrics

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Advances in cardiopulmonary resuscitation studies in mechanically ventilated patients with prone position LAN Xuhong, ZHOU Hongfang, WANG Qian, JIA Donghui, WANG Hengyang, ZHANG Zhigang 2024, 5 (1):  92-96.  doi: 10.3761/j.issn.2096-7446.2024.01.018 Abstract ( 251 )   Save Standard cardiopulmonary resuscitation is the gold standard for saving patients with cardiac arrest，but for patients with prone position，turning to supine position for cardiopulmonary resuscitation requires additional human resources，and increases the time of the brain and heart without blood flow，which misses the "golden time" of cardiopulmonary resuscitation. Therefore，this paper provides a reference basis for clinical practice by integrating the existing evidence and reviewing from the origin and development of prone position cardiopulmonary resuscitation，guidelines recommendations，implementation principles，key technical points，defibrillation，effectiveness and feasibility，safety and limitations. Related Articles | Metrics