对于接受机械呼吸的危急病患者,没有镇静的协议:一个随机试验
Thomas Strøm1, Torben Martinussen, Palle Toft
1Department of Anesthesia and Intensive Care Medicine, Odense University Hospital, University of Southern Denmark, Denmark. t.s@dadlnet.dk
Lancet (London, England)
|February 2, 2010
概括
没有镇静 危急病患者在机械通风上显著增加了没有呼吸器的日子. 与中断镇静相比,这种方法还减少了重症监护室和医院住院的时间.
科学领域:
- 临界护理医学 临界护理医学
- 呼吸系统疗法 呼吸系统疗法
- 药理学 药理学是指药理学的学科.
背景情况:
- 连续镇静是机械呼吸患者的标准.
- 每日休止镇静剂显示有好处.
- 在一个ICU中实施了无镇静的协议.
研究的目的:
- 为了比较无镇静方案与每日镇静中断的疗效.
- 为了确定是否没有镇静可以减少机械通风的持续时间.
主要方法:
- 140名在机械通风中的危急病患被随机 (1:1) 分给没有镇静剂或每天中断镇静剂.
- 主要结局:28天内没有机械通风的几天.
- 二次结果:住院时间长度,以及在ICU和医院住院的时间长度.
主要成果:
- 没有任何镇静剂组在没有机械通风的情况下的日数显著增加 (13.8 vs 9.6 天).
- 没有镇静与更短的ICU和住院时间有关.
- 在没有镇静剂的组中,兴奋性妄想更频繁.
结论:
- 在机械通风的危急病患没有镇静,增加了没有通风的天数.
- 需要进一步的多中心研究来验证这些发现.
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