集中治療室での血液ガス測定の制御
D Roberts1, P Ostryzniuk, E Loewen
1Department of Medicine, University of Manitoba, Winnipeg, Canada.
Lancet (London, England)
|June 29, 1991
まとめ
血液ガス分析プロトコルの導入により,集中治療室での検査頻度は44%減少しました. この変化は,患者の人口統計,疾患の重症度,またはアウトカムに影響を与えることなく発生し,効果的なプロトコル実装を示しています.
科学分野:
- クリティカルケア・メディシン
- 臨床病理学 臨床病理学とは
- ヘルスケア・マネジメント・ヘルスケア・マネジメント
背景:
- 血液ガス分析は,集中治療室 (ICU) で一般的な診断ツールです.
- 診断試験の指示に関するプロトコルは,リソースの利用を最適化し,不要な手順を減らすことを目的としています.
- 成人ICUにおける血液ガス分析頻度に対するこのようなプロトコルを実施する影響は,評価を必要とする.
研究 の 目的:
- 成人の集中治療室における血液ガス測定の頻度に関する指示のプロトコルの効果を評価する.
- プロトコルが患者の特徴,疾患の重症度,または臨床的結果に影響を与えたかどうかを判断する.
- 動脈および肺動脈カテーテルの使用への影響を評価する.
主な方法:
- 2つの成人集中治療室で,プロトコルの実施前7カ月,実施後12カ月という2つの期間における将来的なデータ収集.
- 人口統計,診断,結果,介入データを収集する.
- 血液ガス分析の頻度の比較,プロトコル前期とプロトコル後期.
主要な成果:
- 2つの期間間の人口統計的特徴,疾患の重症度またはタイプ,生存率,または動脈または肺動脈カテーテルの使用頻度において有意な違いは観察されなかった.
- プロトコルの導入後,血液ガス分析の頻度が統計的に有意に44%減少することが観察されました (p <0.001).
結論:
- 血液ガス分析の指標に関するプロトコルの導入により,成人のICUでのこの調査の頻度は効果的に減少しました.
- プロトコルの実施により,血液ガス検査の有意な減少を達成したが,患者の治療結果や他の侵襲的なモニタリングのためのリソース利用に悪影響を及ぼさなかった.
- これは,エビデンスベースのプロトコルが,重症病院での診断テストの利用を成功裏に導くことができると示唆しています.
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