接受输液养的患者的手术前禁食政策:一项全国调查
Jamie L Sparling1, Alexander Nagrebetsky1, Ariel L Mueller1
1Department of Anesthesia, Critical Care, & Pain Medicine, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA.
JPEN. Journal of parenteral and enteral nutrition
|August 6, 2023
概括
危急病患者经常因在手术前禁食而面临营养不足. 目前医院的管道食前程序的政策有很大差异,往往比口服的指导方针更宽容.
科学领域:
- 关键护理医学 关键护理医学
- 手术营养是指手术营养.
- 患者安全 患者安全
背景情况:
- 危急病患者在手术前长时间禁食后会出现营养不足.
- 目前的指导方针缺乏明确的程序前禁食管的患者,创造实践的不确定性.
- 对于大多数接受输液管养的患者来说,吸气风险通常较低.
研究的目的:
- 描述美国当前的机构禁食实践,用于接受输液管养的重病患者.
- 根据气道状况,肠道进入类型和外科手术程序来检查禁食实践.
- 为了识别学术机构之间禁食政策的差异.
主要方法:
- 一项调查分发给了美国学术机构的有目的样本.
- 响应将政策分类为限制性 (6-8小时) 或宽容性 (<6小时或程序内).
- 评估了1级创伤中心,烧伤中心和其他中心之间的差异.
主要成果:
- 实现了40.3%的响应率 (56/139个机构).
- 在手术前禁食实践中观察到显著的变化.
- 在有安全气道的患者中,允许性政策更为常见,特别是在1级创伤中心进行特定程序.
结论:
- 目前的医院政策在输管养的患者程序前禁食是不一致的.
- 政策往往比接受口服营养的健康患者更宽容.
- 需要进一步的研究来确定各种禁食实践的安全性和临床影响.
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