准则可以限制氧气的使用吗? 一个回顾性横截面研究,使用例行收集的数据
Usman Talat1, Kelly A Schmidtke2,3, Saval Khanal4
1Alliance Manchester Business School, University of Manchester, M15 6PB, United Kingdom.
概括
在COVID-19大流行期间,氧气疗法经常过度使用,新指南显示其对优化使用的影响有限. 还观察到低于最佳的药物管理,强调了需要改进策略的需要.
科学领域:
- 医学研究 医学研究
- 临床实践 临床实践
- 公共卫生 公共卫生
背景情况:
- 氧气是一种关键的紧急治疗,但不适当使用可能会导致伤害.
- 在COVID-19大流行期间发布了氧气和药物使用的新指南,以优化患者护理.
- 评估遵守这些准则对于评估其有效性至关重要.
研究的目的:
- 评估氧气和药物管理与新发布的COVID-19指导方针在疫情的第一波期间的一致性.
- 为了确定与氧气过量管理和不足管理相关的因素.
- 为了评估甲的吸收指南.
主要方法:
- 对2020年4月至9月期间入院的8751名COVID-19患者进行了回顾性横截面研究.
- 分析SpO2对氧气指南的遵守情况,按慢性阻塞性肺病 (COPD) 状态分层.
- 多位数回归以确定与氧气使用相关的因素,并计算德克萨米他的剂量.
主要成果:
- 氧气仅在41.6%的时间内按照指导方针使用,过量使用 (55.0%) 明显比不足使用 (3.5%) 更常见.
- 与没有COPD的患者相比,COPD患者 (25.2%) 的坚持较低 (43.7%),COPD组的过度使用率较高 (71.8%).
- 在指导方针更新后,只有12.6%的符合条件的患者接受了德甲.
结论:
- 在COVID-19流行病的初期阶段,氧气和药物的低最佳使用普遍存在.
- 仅仅现有的指导方针不足以确保最佳的氧气治疗使用.
- 需要行为策略和政策干预来改善临床实践中的氧气和药物管理.
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