Regular nursing and respiratory tract humidification method
All patients used disposable tracheotomy suits produced by Covidien llcs, and a disposable sputum suction tube was used for open sputum inhalation (Figure 1A). Sterilized injection water was chosen as uniform gas humidifying fluid, and different humidifying methods were assessed. A group: routine treatment or nursing + oxygen spraying, 20ml humidifying fluid was added every 2 hours and replaced every 24 hours, the oxygen spraying devices were purchased from Excellentcare Medical Ltd (Huizhou), product name: disposable medical atomizer (EM06-007), and how the devices were connected were shown in Figure 1A. Group B: routine treatment or nursing + Heat and moisture exchanger (HME), and the artificial nose were replaced every 24 hours or the sponge was contaminated. The HME device was provided by InterSurgical Company (Changzhou), the product name is: Hydro-Trach II HME with oxygen tubing. The tube was directly connected to the end of the tracheal cannula, the middle tube was connected with the oxygen tube, and the sponge at two sides was designed to collect the heat and moisture exhaled by the patients, and the devices were shown in Figure 1B. Group C: Routine treatment or nursing + heating and humidification treatment (Hamilton Medical, SFDA(I)20093540261). MR810 heating base with MR 370 heating wet tank and heating wire ventilator humidifying pipe connecting trachea sleeve, removing the other pipe loop, retaining Y-shaped joint, placing thermometer on the patient side of the pipeline, monitoring the temperature of the water mist at the entrance, Close the heated wetted tank back to the junction, the oxygen tube is connected to the small side hole of the heated wetted tank, and the sterilized injection water is connected to the oxygen tube through the adjustable infusion device to keep the liquid in the heated wetted tank within normal capacity (Figure 1C). The temperature of the atomizer tank is adjusted to 39-41 °C, and the temperature before entering the patient’s airway is 35.3 °C according to a previous report13. The pipeline is non-polluted and not replaced. All three groups of patients were given of 3L/min oxygen flow, routine hemostasis, controlling blood pressure, reducing intracranial pressure and giving enteral nutritional support.