面对死亡:影响生命终结决策的因素在重症监护室
Syed Sabih Ul Hassan1, Wajid Ali2, Hamza Khan2
1Centre for Patient Safety, Aga Khan University, Karachi, Pakistan.
Omega
|August 26, 2023
概括
大多数重症监护室 (ICU) 患者有"不要复苏"的命令,这表明有限的终身护理. 诸如年龄,通风持续时间和格拉斯哥昏迷表等因素影响了这些决定.
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.
- 医学伦理 医学伦理
背景情况:
- 在重症监护室 (ICU) 进行终身护理的决定是复杂的.
- 了解影响护理局限性的因素对于以患者为中心的管理至关重要.
- 不复苏命令 (DNR) 是一种常见的护理限制形式.
研究的目的:
- 为了确定在ICU中有限的终身护理的频率.
- 确定与决定限制对已故患者的护理相关的因素.
主要方法:
- 对于在阿迦汗大学的重症监护室中死亡的所有患者的医疗记录的回顾性审查.
- 统计分析以确定与终身护理限制相关的变量.
主要成果:
- 大多数患者在死亡时有"不要复苏"的命令.
- 六个变量与限制护理的决定有显著的关联:患者年龄,性别,机械通风的持续时间,格拉斯哥昏迷表 (GCS) 评分≤8 (在入院前24小时内在任何时候),以及入院后24小时内血管压缩剂的平均动脉压力<65毫米升.
结论:
- 终身护理限制,特别是DNR命令,在ICU中很常见.
- 特定的临床变量 (年龄,性别,通风持续时间,GCS,MAP) 与这些决定有关.
- 这些因素需要在临终讨论中仔细考虑,以优化患者护理.
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