与提取相比,与放弃节奏和除器相关的结果
Sean D Pokorney1, Xiaojuan Mi2, Robert K Lewis2
1From Duke University Medical Center, Durham, NC (S.D.P., R.K.L., E.P.Z., S.M.A.-K., D.D.H., J.P.P.); Duke Clinical Research Institute, Durham, NC (S.D.P., X.M., M.G., E.P.Z., S.M.A.-K., J.P.P.); Brigham and Women's Hospital, Boston, MA (L.M.E.); and University of Miami, FL (R.G.C.). sean.pokorney@duke.edu.
Circulation
|August 24, 2017
概括
对心脏器械的选择性取显示出与封闭和放弃的生存率相似. 然而,提取可以降低五年内设备感染的风险.
科学领域:
- 心脏病学
- 医疗设备技术
- 健康成果研究
背景情况:
- 在心脏植入式电子设备 (CIED) 的患者中,管理至关重要.
- 在限制和放弃后的长期结果尚未得到充分证实.
研究的目的:
- 在CIED患者中比较提取与限制和放弃的长期结果.
- 评估两种管理策略的死亡率,感染率和修订率.
主要方法:
- 对5%的医疗保险CIED植入物 (2000-2013) 样本的分析.
- 对患者进行取与限制/放弃的比较 (不包括感染病例).
- 用于评估1年和5年的结果的多变量考克斯比例危险模型.
主要成果:
- 在6859名患者中,16. 2%接受了提取,83. 8%接受了限制/放弃.
- 抽取组的患者年轻,男性较少,停留时间较短,并出现较少的并发症.
- 提取与较低的5年设备感染风险相关 (aHR为0. 78;P=0. 027),但死亡率或改没有差异.
结论:
- 对于非传染性病症,选择性取提供与限制和放弃相比的长期存活率.
- 提取与五年后设备感染的发生率降低有关.
相关概念视频
Cardiopulmonary Resuscitation III: AED Use
840
Introduction to AEDAn Automated External Defibrillator (AED) is a portable medical device that analyzes the heart's rhythm and, if necessary, delivers an electrical shock to help the heart re-establish an effective rhythm during sudden cardiac arrest (SCA). SCA occurs when the heart suddenly and unexpectedly stops beating, leading to a loss of blood flow to the brain and other vital organs. In such emergencies, time is of the essence, and using an AED, combined with Cardiopulmonary...
840
Cardiomyopathy V: Interprofessional Care
510
Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
510
Cardiomyopathy VII: Pre and Post Operative Nursing Management
393
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
393
Cardiac Catheterization IV: Nursing Management
863
Nursing responsibilities before cardiac catheterization include:Assess for allergies and establish baseline health status.Before cardiac catheterization, assess the patient for allergies to contrast dye. Perform a comprehensive baseline assessment, including vital signs, heart and breath sounds, and a neurovascular assessment of the extremities, noting distal pulses, skin color, and temperature. Instruct the patient to fast for 8-12 hours before the procedure. Evaluate baseline laboratory...
863


