在肯尼亚和埃塞俄比亚获得和使用Capnography
Maziar M Nourian1, Amany Alshibli2, John Kamau3
1Department of Anesthesiology, Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN, 37232, USA. maziarnourian@gmail.com.
Canadian journal of anaesthesia = Journal canadien d'anesthesie
|November 2, 2023
概括
在低收入和中等收入国家 (LMICs) 中,Capnography的使用率很低,但与手术后死亡率的降低有关. 需要进一步的研究来证实LMIC中麻醉监测的这些发现.
科学领域:
- 麻醉学和重症监护医学
- 全球卫生公平性全球卫生公平性
- 医疗器械的利用 医疗器械的利用
背景情况:
- 在低收入和中等收入国家 (LMICs),麻醉和监测设备的访问是有限的,这可能会增加患者的发病率和死亡率.
- 高收入国家的标准监测工具Capnography对LMICs的利用和影响进行了不足的研究.
研究的目的:
- 评估与肯尼亚和埃塞俄比亚的图使用相关的因素.
- 在LMICs中确定卡普诺图使用与患者死亡率 (手术后,24小时和7天) 之间的关联.
主要方法:
- 在肯尼亚和埃塞俄比亚使用2014年至2020年的历史队列数据进行了回顾性观察研究.
- 后勤回归分析,以评估图谱使用与患者/手术特征之间的关联.
- 分析卡普诺图使用与手术内,24小时和7天死亡率之间的调整后的关联.
主要成果:
- 与初级医院和区域麻醉相比,在三级/二级医院和全身麻醉中使用图显著更高.
- 在接受全身麻醉 (OR,0.31;95% CI,0.17至0.48) 的患者中,卡普诺图的使用与术后死亡率显著降低相关.
- 在完全调整后,没有发现图使用与24小时或7天死亡率之间有显著的关联.
结论:
- 在LMICs的Capnography利用率低于高收入国家,在专业环境和全身麻醉中使用率更高.
- 虽然头部摄影显示了手术后死亡率的降低,但需要进一步的研究来验证这些发现.
- 该研究强调,需要改善对图学在提高资源有限的环境中患者安全方面的作用的获取和理解.
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