在重症监护运输和住院期间镇静深度的相关性
Matthew A Roginski1,2, Matthew C Carroll1, Micah L Trautwein2
1Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
Journal of intensive care medicine
|October 31, 2023
概括
在重症监护运输期间的深度镇静不能预测机械通风患者在医院继续深度镇静. 这表明,在护理过渡期间重新评估镇静实践可能会改善患者的治疗结果.
科学领域:
- 关键护理医学 关键护理医学
- 运输医学 运输医学
- 镇静管理 镇静管理
背景情况:
- 机械通风患者需要在运输期间小心地进行镇静管理.
- 医院前镇静深度对医院内结果的影响尚不清楚.
研究的目的:
- 评估在重症监护运输和随后的医院镇静水平期间深度与轻度镇静之间的关联.
- 为了确定运输镇静对机械通风持续时间,住院时间和死亡率的影响.
主要方法:
- 追溯对198名机械呼吸的成年患者的队列审查.
- 评估了运输镇静 (里士满兴奋镇静量表 (RASS) -3至 -5) 和48小时内医院镇静之间的相关性.
- 分析了二次结果,包括通风持续时间,医院/ICU LOS,死亡率,妄想和昏迷.
主要成果:
- 92.4%的患者在运输过程中接受了深度镇静.
- 深度运输镇静与48小时内深度医院镇静没有相关性 (OR 2.41).
- 没有发现与住院时间,ICU停留时间,机械通风持续时间,死亡率,妄想或昏迷的显著相关性.
结论:
- 深度镇静在重症监护运输期间很常见,但不能预测在医院继续深度镇静.
- 护理的转变为重新评估和可能调整镇静策略的机会.
- 需要进一步的研究来优化设施间运输期间的镇静协议.
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