相关实验视频
Updated: Jul 18, 2025

16:11
Implantation of the Syncardia Total Artificial Heart
Published on: July 18, 2014
35.3K
在左心室辅助装置植入和气管切除术后的临床预测因素和结果
Harveen K Lamba1, Lucy D Hart1, Qianzi Zhang2
1Division of Cardiothoracic Transplantation and Circulatory Support, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas.
Texas Heart Institute journal
|August 25, 2023
概括
持续流动左心室辅助装置 (CF-LVAD) 植入后需要气管切除术的患者面临着明显更差的生存结果. 仔细的患者选择和全面的呼吸管理对于改善生存率至关重要.
科学领域:
- 心脏病学 心脏病学
- 胸部外科手术 胸部外科手术
- 关键护理医学 关键护理医学
背景情况:
- 手术后呼吸衰竭是心脏手术后的严重并发症,影响高达10%的患者.
- 持续流动的左心室辅助装置 (CF-LVAD) 植入是一种拯救生命的程序,但可能会出现呼吸道并发症.
- 有限的研究存在于CF-LVAD接受者的气管切除术对生存的影响.
研究的目的:
- 在CF-LVAD患者中确定需要气管切除术的呼吸衰竭风险因素.
- 为了比较CF-LVAD患者接受气管切除术和未接受气管切除术患者之间的生存结果.
主要方法:
- 连续接受初级CF-LVAD植入的患者 (2002-2019) 的回顾性审查.
- 倾向性得分与对照对照对组之间的基线差异进行匹配.
- 多变量逻辑回归用于风险因素分析和90天生存率;卡普兰-梅尔分析用于中期生存率.
主要成果:
- 在664名CF-LVAD患者中,有16.0%需要进行气管切除术.
- 气管切除术患者年龄较大,更有可能需要手术前的机械支持/输管,并且具有较高的肌素水平.
- 气管切除术与匹配前后的30天,90天,1年和3年生存率明显恶化有关.
结论:
- 需要气管切除术的呼吸衰竭在CF-LVAD患者中显著增加死亡风险.
- 患有呼吸衰竭的高风险患者需要仔细考虑CF-LVAD植入.
- 手术前后的积极呼吸管理对于改善结果至关重要.
相关概念视频
Cardiomyopathy V: Interprofessional Care
16
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...
16
Tracheostomy Decannulation
236
Tracheostomy decannulation is a significant milestone in the liberation of mechanically ventilated patients. Despite its importance, there is no universally accepted protocol for this procedure. This demands an evidence-based, individualized approach.
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...
236
Tracheostomy: Procedure and Tubes
719
A tracheostomy is a surgical procedure that creates an artificial opening into the trachea, typically at the second or third cartilaginous ring level. This opening allows the insertion of a tracheostomy tube, which can replace an endotracheal tube, provide mechanical ventilation, bypass an upper airway obstruction, or remove accumulated tracheobronchial secretions.
Tracheostomy tubes can be made of semiflexible plastic (polyurethane or silicone), rigid plastic, or metal, and they come in...
Tracheostomy tubes can be made of semiflexible plastic (polyurethane or silicone), rigid plastic, or metal, and they come in...
719
Tracheostomy Care II: Procedure
239
Tracheostomy care is an essential nursing skill that involves cleaning and maintaining a tracheostomy tube to prevent infection and other complications. Here's a step-by-step guide explaining each procedure with its rationale. Note that disposable gloves are to be worn at all times and changed as often as needed to maintain a sterile work environment, and to protect both patient and healthcare worker.
Step 1: Perform hand hygiene, and put on personal protective equipment: gown, gloves, mask...
Step 1: Perform hand hygiene, and put on personal protective equipment: gown, gloves, mask...
239
Tracheostomy Care I: Pre-procedural Steps
236
A tracheostomy is a surgical technique that involves making an incision in the neck to provide access to the trachea. It is frequently used in medical conditions such as airway obstruction and prolonged mechanical ventilation. Effective nursing management is crucial for the long-term success of a tracheostomy.
Required Equipment
The equipment necessary for tracheostomy care includes:
Required Equipment
The equipment necessary for tracheostomy care includes:
236
Oxygen Delivering System III: Tracheostomy and T-piece
1.2K
Oxygen delivery is critical in clinical care, especially for patients with respiratory disorders or those undergoing surgical procedures. Various systems, such as tracheostomy and the T-piece, deliver oxygen to the lungs, ensuring adequate arterial oxygenation.
Tracheostomy
A tracheostomy is a surgically created opening (stoma) in the anterior part of the trachea. It is used to establish a patient airway, bypass an upper airway obstruction, simplify the removal of secretions, permit long-term...
Tracheostomy
A tracheostomy is a surgically created opening (stoma) in the anterior part of the trachea. It is used to establish a patient airway, bypass an upper airway obstruction, simplify the removal of secretions, permit long-term...
1.2K

