一项关于电子医疗记录的高度数据精度的前性研究,用于肺保护通风的潮体积计算
Salman Mohamed1, Kavita Batra2,3, Nicole Pang1
1Kirk Kekorian School of Medicine at University of Nevada, Las Vegas, NV.
Medicine
|November 28, 2023
概括
准确的潮体积 (TV) 设置对于肺部保护性通风至关重要. 这项研究发现,在预测体重 (PBW) 计算中使用记录身高而不是测量身高导致过高估计的TV,从而增加了患者死亡风险.
科学领域:
- 关键护理医学 关键护理医学
- 呼吸系统生理学 呼吸系统生理学
- 患者安全 患者安全
背景情况:
- 使用基于预测体重 (PBW) 的潮体积 (TV) 进行肺保护性通风是标准做法.
- 目前的方法依赖于记录的患者身高,这可能不准确.
- 不准确的身高测量可以导致电视设置不正确,可能会伤害患者.
研究的目的:
- 为了验证电视设置对肺部保护通风的准确性.
- 为了比较基于PBW的TV计算的记录高度与测量高度.
- 识别导致医疗记录中高度估计过高的因素.
主要方法:
- 一个单一中心研究比较基于PBW的电视从记录高度计算到从床边测量高度的电视.
- 在入院后24小时内,用金属带测量患者的身高.
- 统计分析确定了高度高估的预测因素,并比较了死亡率.
主要成果:
- 从记录高度计算的TV显著大于从测量高度计算的TV (P < .01).
- 高度高估组中超过一半的患者接受的TV超过8mL/kg的PBW,基于测量的身高.
- 高度高估与更高的住院患者死亡率有关 (38.5%对20%,P < .01).
结论:
- 记录的高度导致过高估计的基于PBW的电视在球场计限制的设置.
- 身高高估的危险因素包括女性性别,亚洲族裔和缺失的驾驶执照数据.
- 精确的高度测量对于精确的通风设置和改善患者结果至关重要;应探索替代方法.
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