根据COPD急性呼吸衰竭患者非侵入性通风启动时间的临床结果:回顾性队列研究
Lara Pisani1,2, Gabriele Corsi1,2, Marco Carpano1,2
1Alma Mater Studiorum, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40126 Bologna, Italy.
Journal of clinical medicine
|September 28, 2023
概括
在COPD患者中,针对急性呼吸衰竭 (ARF) 启动非侵入性通风 (NIV) 并不会在夜间或非工作日增加衰竭率. 无论时间如何,结果都保持一致,即使在下班时间有更长的延迟.
科学领域:
- 呼吸系统医学 呼吸系统医学
- 关键护理医学 关键护理医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 这是一个很棒的节目,这是一个很棒的节目.
- 周末效应是周末的效应.
- 周末死亡率的增加是一个有记录的现象,可能是由于人员和资源的减少.
- 关于入院时间对患者结果的影响的先前研究,特别是需要非侵入性通风 (NIV) 的急性呼吸衰竭 (ARF),产生了有争议的结果.
- 关于NIV启动时间 (白天与夜晚,工作日与非工作日) 对慢性阻塞性肺病 (COPD) 患者临床结果的特定影响的数据有限.
研究的目的:
- 调查NIV启动时间对ARFCOPD患者临床结果的影响.
- 为了确定NIV故障率是否在白天和夜晚之间,以及在工作日和非工作日之间有所不同.
- 评估在非工作时间内延迟启动NIV和患者结果之间的关系.
主要方法:
- 观察性,单心,回顾性队列研究.
- 包括266名需要NIV的COPD患者,诊断到NIV启动时间间隔小于48小时.
- 关于患者特征,NIV参数和临床结果的前性数据收集,包括NIV失败 (输管或在医院死亡).
主要成果:
- 很大一部分患者 (39%) 在NIV启动时没有酸性 (pH 7.38 ± 0.09).
- 在白天与夜间,工作日与非工作日,以及夜间/非工作日与白天工作日相结合时,NIV失效率相似.
- 虽然夜间NIV启动与更长的延迟有关 (219分钟与115分钟),但这并没有显著影响NIV结果.
结论:
- 开始NIV的时间 (白天与夜间,工作日与非工作日) 似乎不会影响COPD患者的NIV失败率.
- 即使在"安静"的时间 (夜间或非工作日),经验丰富的中心也可以保持可比的NIV成功率.
- 这些发现表明,适当的培训和资源管理可以减轻非工作时间入院对患者结果的潜在负面影响.
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