瑞典心脏骤停后重症监护:对当前临床实践的调查
Sara Järpestam1, Louise Martinell2, Christian Rylander3
1School of Medical Sciences, University of Örebro, Örebro, Sweden.
Acta anaesthesiologica Scandinavica
|June 14, 2023
概括
瑞典ICU现在在心脏骤停后的护理中使用正常热量,大多数中心评估神经学预后. 然而,这种评估的方法在各医院之间有所不同.
科学领域:
- 密集护理医学 密集护理医学
- 神经学 神经学
- 心脏病学 心脏病学
背景情况:
- 欧洲指南建议在心脏骤停后进行有针对性的温度管理 (TTM).
- 一项试验发现低温和正常热与发烧治疗之间的结果没有差异.
- 存在TTM协议和神经评估的变化,需要了解瑞典当前的临床实践.
研究的目的:
- 调查瑞典重症监护室 (ICU) 的复苏后护理现行做法.
- 确定温度目标和神经预后评估的方法.
- 了解瑞典ICU的临床实践中的差异.
主要方法:
- 在2022年春天对53个瑞典2级和3级ICU进行了调查,并于2023年4月进行了后续调查.
- 该调查使用电话或电子邮件通信来收集数据.
- 数据分析的重点是温度管理和神经评估协议.
主要成果:
- 在48个符合条件的ICU中,43个 (90%) 响应.
- 所有响应的ICU (2023) 在心脏骤停后应用了正常热量 (36-37.7°C).
- 在88%的ICU中存在详细的神经预后评估程序,评估通常在复苏后72-96小时进行.
结论:
- 瑞典ICU主要使用常温与早期发烧治疗进行心脏骤停后的护理.
- 几乎所有ICU都建立了神经学预后评估的例行程序.
- 在瑞典医院之间,用于预后评估的可用方法存在显著差异.
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