29か国からの重症患者における挿管の慣行と有害な挿管期間の事象
Vincenzo Russotto1,2, Sheila Nainan Myatra3, John G Laffey4,5
1School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.
JAMA
|March 23, 2021
まとめ
重症患者の呼吸道管内置は,しばしば有害事象,特に心血管の不安定化につながります. この研究は,これらの合併症の高い発生率を強調し,呼吸道管理の改善の必要性を強調しています.
科学分野:
- クリティカル ケア 医療
- 麻酔科
- 緊急 医療
背景:
- トラキア管注入は重症の患者に よく行われますが リスクが高いものです
- 挿管中にまたは直後に発生した有害事象に関するデータは限られている.
研究 の 目的:
- 潜伏期間の有害事象の発生率と種類を決定する.
- 重症患者における現在の気管管内管術の評価
主な方法:
- 重症患者の呼吸道管理の効果とベストプラクティスを理解するための国際観察研究 (INTUBE) には,5つの大陸の197か所から2964人の患者が参加した.
- この前向きなコホート研究では,2018年10月から2019年7月のデータを分析した.
- 主要な有害事象には,心血管の不安定性,重度の低酸素症,または静脈管注入後30分以内に心停止が含まれる.
主要な成果:
- 患者の45%以上は,少なくとも1つの主要な有害事象を経験した.
- 心血管不安定が最も頻繁に発生した (42. 6%),続いて重度の低酸素症 (9. 3%) と心停止 (3. 1%) であった.
- 集中治療室での死亡率は32. 8%でした.
結論:
- トラキア管注入を受けた重症患者の間での有害事象は一般的です.
- 心血管不安定が 主な合併症です
- 研究結果は,集中治療施設での警戒と最適化された呼吸道管理戦略の必要性を強調しています.
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