一个算法方法的有效性,在生命结束时的风扇退出:一个阶段集群随机试验
Margaret L Campbell1, Hossein N Yarandi1
1College of Nursing, Wayne State University, Detroit, Michigan, USA.
Journal of palliative medicine
|August 18, 2023
概括
一种算法方法改善了患者在呼吸机停用期间的舒适度,减少了呼吸困扰. 与通常的护理相比,这种方法也减少了阿片类药物和二二类药物的使用.
科学领域:
- 关键护理医学 关键护理医学
- 抚慰性护理是一种缓解性护理.
- 呼吸系统疗法 呼吸系统疗法
背景情况:
- 呼吸机被取消会带来呼吸困难的高风险.
- 由于患者异质性,需要采用标准化,以患者为中心的方法.
- 当前的方法可能无法在这种息治疗过程中充分满足个体患者的需求.
研究的目的:
- 为了评估一个算法方法,用于通风器的撤回.
- 用算法比较患者的呼吸舒适度与通常的护理.
- 评估阿片类药物/二二类药物使用和生存时间的差异.
主要方法:
- 在五个地点进行了步集群随机试验.
- 患者接受了通常的护理或一种算法方法来进行呼吸器退出.
- 呼吸困扰用呼吸困扰观察量表 (RDOS) 测量呼吸困扰;药物使用量化.
主要成果:
- 与常规护理相比,算法手臂的呼吸困难明显减少 (p=0.0013).
- 在算法组中,服用阿片类药物和二类药物的次数较少.
- 算法组中58%的患者被断奶,与对照组中的一步停止不同.
结论:
- 以患者为中心的算法有效地提高了呼吸舒适度在呼吸机撤回期间.
- 客观地测量痛苦 (RDOS) 和及时干预可以减少药物需求.
- 算法方法为管理通风器退出提供了一个优秀的策略.
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