在烧伤手术前的安非他胺阳性不会对手术后的结果产生不利影响
Nada Rizk1, David Crawford2,3, Yvonne Karanas4
1Department of Surgery, Stanford University School of Medicine, 770 Welch Road suite 400, Palo Alto, CA 94304, USA.
概括
胺阳性烧伤患者可以安全地接受手术,而不必等待负毒理学结果. 连续测试是不必要的,因为操作时间不会影响结果或操作管理.
科学领域:
- 创伤外科 手术 创伤外科
- 烧伤护理 烧伤护理
- 毒理学 毒理学 毒理学
背景情况:
- 在烧伤患者中使用安非他因血液动力学不稳定性和改变的生理学而带来治疗挑战.
- 对于安非他命阳性烧伤患者的手术时间存在显著差异.
研究的目的:
- 调查烧伤患者中手术时间的安全性和影响,这些患者的安非他胺毒理学为阳性.
- 为了确定延迟手术到阴性安非他毒理学影响手术内管理或患者的结果.
主要方法:
- 来自两家烧伤中心 (2017-2022) 的回顾性数据分析,有不同的毒理学协议.
- 在入院后一次中心查毒理学结果与每日查中心之间的结果比较,直到负数.
- 经烧伤严重程度和住院日调整后的物流回归分析,以指数操作.
主要成果:
- 没有显著的差异在需要血管活性剂的中心之间的手术内 (P = .821).
- 较大的烧伤尺寸 (身体表面积>20%) 与血管活性支持 (adj. 其他国家 (OR 13.42).
- 死亡率,手术数量,中风发病率和住院时间在队列之间是相似的.
结论:
- 推迟烧伤切除,直到负的安非他胺毒理学结果是不必要的,也不会改善手术内管理或患者的结果.
- 连续毒理学测试不需要指导安非他命阳性烧伤患者的手术时间.
- 烧伤严重程度比安非他命状态时间更重要地预测了手术内血管活性支持需求.
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