Impact of comprehensive nursing based on the ``3H'' theory on blood gas, recovery speed and lung function in children with severe pneumonia

Background: This study aims to evaluate the effects of comprehensive nursing based on the “3H” theory on blood gas parameters, recovery speed and lung function in children with severe pneumonia. Methods: An analysis was conducted on clinical data from 90 children diagnosed with severe pneumonia who were treated at our hospital between November 2022 and December 2023. They were randomly divided into two groups based on the computer random number table method: a study group, which received comprehensive nursing based on the “3H” theory in addition to routine care (n = 45), and a control group, which received only routine care (n = 45). The recovery speed, blood gas indexes, lung function indexes, and family satisfaction were compared between the two groups. Results: Before treatment, there were no significant differences between the two groups in terms of arterial partial pressure of oxygen (PaO2), arterial oxygen saturation (SaO2), arterial partial pressure of carbon dioxide (PaCO2), forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), maximum voluntary ventilation (MVV), peak expiratory flow (PEF) and the ratio of FEV1 to FVC (FEV1/FVC) (p > 0.05). After treatment, the study group showed higher compliance, family satisfaction, FEV1, FVC, MVV, PEF, PaO2 and SaO2 levels, and shorter times for cough relief, fever reduction, improvement in shortness of breath, disappearance of lung rales, hospitalization and PaCO2 levels. These differences were all statistically significant (p < 0.05). Conclusions: Comprehensive care under the “3H” theory can significantly improve the recovery speed, blood gas levels, pulmonary function and family satisfaction in children with severe pneumonia. The ISRCTN Registration: ISRCTN13393172.

“3H” theory; Comprehensive nursing; Severe pneumonia; Blood gas indicators; Recovery speed; Lung function

[1] Zhu Z, Zhang T, Guo W, Ling Y, Tian J, Xu Y. Clinical characteristics of refractory mycoplasma pneumoniae pneumonia in children treated with glucocorticoid pulse therapy. BMC Infectious Diseases. 2021; 21: 126.

[2] Zheng Y, Hua L, Zhao Q, Li M, Huang M, Zhou Y, et al. The level of D-dimer is positively correlated with the severity of mycoplasma pneumoniae pneumonia in children. Frontiers in Cellular and Infection Microbiology. 2021; 11: 687391.

[3] Zhou Y, Hu M, Ye B, Chen Z, Zhang Y. Early prediction of necrotizing pneumonia from mycoplasma pneumoniae pneumonia with large pulmonary lesions in children. Scientific Reports. 2020; 10: 19061.

[4] Zhao Q, Yang J, Sheng Y, Zhuang M, Qi M. Study on the therapeutic effect of azithromycin combined with glucocorticoid on pulmonary function and inflammatory response in children with pneumonia. Journal of Healthcare Engineering. 2022; 2022: 5288148.

[5] Luo W, Liu Y, Wen C, Chen X, Zhang J. Bundled care combined with animated educational videos can promote the recovery of severe pneumonia in children: a case-control study. Medicine. 2024; 103: e38437.

[6] Li J. The effect of personalized comprehensive care on the nursing care of severe pneumonia patients. Journal of Clinical and Nursing Research. 2024; 8: 71–77.

[7] Sheikh M, Ahmad H, Ibrahim R, Nisar I, Jehan F. Pulse oximetry: why oxygen saturation is still not a part of standard pediatric guidelines in low-and-middle-income countries (LMICs). Pneumonia. 2023; 15: 3.

[8] Bai L, Yang L, Shi X, Huang W. Effect of PDCA circulation nursing intervention on prognosis of patients with severe pneumonia. American Journal of Translational Research. 2022; 14: 252–263.

[9] Shahrin L, Chisti MJ, Shahid ASMSB, Rahman ASMMH, Islam MZ, Afroze F, et al. Injectable amoxicillin versus injectable ampicillin plus gentamicin in the treatment of severe pneumonia in children aged 2 to 59 months: protocol for an open-label randomized controlled trial. JMIR Research Protocols. 2020; 9: e17735.

[10] Wang M, Li H, Yang J, Wang M, Liu J. Clinical efficacy enhancement of a Chinese herbal injection in the treatment of mycoplasma pneumonia in children: a protocol of randomized controlled trial. Medicine. 2021; 26: e25135.

[11] Zimmerman S, Sloane PD, Ward K, Wretman CJ, Stearns SC, Poole P, et al. Effectiveness of a mouth care program provided by nursing home staff vs. standard care on reducing pneumonia incidence: a cluster randomized trial. JAMA Network Open. 2020; 3: e204321.

[12] Levitt D. Transforming the hospital-style nursing home to a centre for living. Healthcare Management Forum. 2022; 35: 35–38.

[13] Field MR, Ambroggio L, Lorenz D, Shah SS, Ruddy RM, Florin TA. Time to clinical stability in children with community-acquired pneumonia. Pediatrics. 2024; 153: e2023063480.

[14] Wang X, Qiu Y, Xu T, Chen Y, Ying C. Effect observation of optimized individualized nursing care applied to ICU patients with severe pneumonia. Emergency Medicine International. 2022; 2022: 6529558.

[15] Yang W, Zhang L. Observation of the curative effect of conservative oxygen therapy in mechanical ventilation of patients with severe pneumonia. Chinese Critical Care Medicine. 2021; 33: 1069–1073. (In Chinese)

[16] Wang S, Dong Y, Wang J, Leng L, Song X, Huang W. The protective effect of ulinastatin combined with Xuebijing on myocardial injuries in patients with severe pneumonia. American Journal of Translational Research. 2021; 13: 11745–11751.

[17] Zhang M, Li X, Bai Y. Prone position nursing combined with ECMO intervention prevent patients with severe pneumonia from complications and improve cardiopulmonary function. American Journal of Translational Research. 2021; 13: 4969–4977.

[18] Wang ZL, He Y, Luo ZX. Continuous positive airway pressure in children with severe pneumonia: a meta-analysis. World Journal of Pediatrics. 2020; 16: 637–641.

[19] Xue M, Da C. The protective effect of Qingfei Huatan decoction on pulmonary function and its influence on the immunological function in children with severe pneumonia. American Journal of Translational Research. 2021; 13: 9404–9412.

[20] Xiao T, Chen F, Wan Z. Study on effects of care bundles on patients with severe pneumonia complicated with respiratory failure. American Journal of Translational Research. 2021; 13: 10942–10949.

[21] Wang M, Li J, Li W, Tian H, Kang X. The effect of EBN combined with integrated hierarchical accountability nursing on patients with severe pneumonia. American Journal of Translational Research. 2021; 13: 5610–5616.

[22] Yu T, Wang N, Li A, Xu Y. Clinical evaluation of targeted sedation nursing combined with comprehensive nursing in children with severe pneumonia. Medicine. 2024; 103: e36317.