来自29个国家的重症患者的输入实践和周边输入不良事件
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
概括
重症患者的气管输入经常导致不良事件,特别是心血管不稳定. 这项研究强调了这些并发症的高发病率,强调了改善呼吸道管理的必要性.
科学领域:
- 危急护理医学
- 麻醉学
- 紧急医疗
背景情况:
- 呼吸道输管是常见的高风险手术.
- 在输管过程中或输管后立即发生的不良事件的数据有限.
研究的目的:
- 确定化前不良事件的发生率和类型.
- 评估目前在重症患者中的气管输液实践.
主要方法:
- 国际观察研究以了解严重病患者呼吸道管理的影响和最佳实践 (INTUBE) 涉及5大洲197个地点的2964名患者.
- 这项前性队列研究分析了2018年10月至2019年7月的数据.
- 主要不良反应包括心血管不稳定,严重的低氧化或输管后30分钟内心脏骤停.
主要成果:
- 超过45%的患者经历了至少一个主要的输入前不良事件.
- 心血管不稳定是最常见的事件 (42. 6%),其次是严重的低氧化 (9. 3%) 和心脏骤停 (3. 1%).
- 在重症监护室 (ICU) 的死亡率为32. 8%.
结论:
- 在接受气管输管治疗的重症患者中,主要的周周输管不良事件很常见.
- 心血管不稳定是主要的并发症.
- 调查结果强调需要警和优化呼吸道管理策略.
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