在患有严重突胸部创伤的患者中,延长机械通风的早期风险因素:一项回顾性队列研究
Aran Gilaed1, Nadeem Shorbaji2, Ori Katzir3
1Department of General Thoracic Surgery, Rambam Health Care Campus, Israel.
Injury
|November 17, 2023
概括
男性性别,年龄较大,严重的头部创伤,以及在入院时需要超过5个血液单位是严重的突击胸部创伤患者长期机械呼吸 (MV) 的关键预测因素. 早期识别有助于管理这些高风险病例.
科学领域:
- 关键护理医学 关键护理医学
- 创伤外科 手术 创伤外科
- 呼吸系统医学 呼吸系统医学
背景情况:
- 对于严重的胸部创伤,经常需要机械通风 (MV).
- 早期预测MV持续时间对于临床决策至关重要.
- 鉴定严重的形胸部创伤中长期MV的危险因素是必不可少的.
研究的目的:
- 为了确定早期的独立风险因素,长时间的机械呼吸 (MV) 在成年患者严重的的胸部创伤.
- 为需要扩展MV支持的患者提供临床管理策略的信息.
主要方法:
- 重度突击胸部创伤患者的回顾性单中心队列研究 (2014年1月 - 2020年12月).
- 主要结局:长时间的MV (>14天).
- 多变量后勤回归分析以确定独立的风险因素.
主要成果:
- 男性的性别,年龄较大,严重的头部创伤和在入院时输血的>5个血液单位独立地与长时间的MV (>14天) 相关.
- 肋骨骨折数和肺伤程度预测MV>7天,但不>14天.
- 在没有头部创伤的患者中,年龄,呼吸道并发症,较差的初始p/f比率和输血的>5个血液单位预测了长时间的MV.
结论:
- 已经确定了严重的突击胸部创伤中长期MV的几个早期预测因素.
- 患有已确定的风险因素的患者需要更密切的监测和潜在的干预措施来缩短MV持续时间.
- 年轻,血液动力学稳定的没有头部受伤的患者,即使有广泛的肺伤或肋骨骨折,患长期MV的风险较低.
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