确定心脏性休克患者的护理水平
Miguel Alvarez Villela1, Danni Fu2, Kylie Roslin1
1Department of Cardiology, Lenox Hill Hospital, Northwell Health, New York, NY, United States.
Frontiers in cardiovascular medicine
|November 29, 2023
概括
本研究定义了基于机械循环支持 (MCS) 能力的心脏性休克 (CS) 护理水平. 虽然更高级别的中心管理年轻患者和特定的CS类型,但调整后的死亡率在各级之间没有显著差异.
科学领域:
- 心脏病学 心脏病学
- 医疗保健系统 医疗保健系统
- 医疗技术 医疗技术 医学技术
背景情况:
- 专家一致认为,需要多层次的心脏性休克 (CS) 护理系统.
- 对于CS的不同级别护理 (LOC) 的实际定义仍然不清楚.
研究的目的:
- 根据机械循环支持 (MCS) 能力,在心脏性休克 (CS) 方面实用性地将医院分为不同级别的护理 (LOC).
- 在这些定义的LOC.中比较患者人口统计,管理策略和结果.
主要方法:
- 医院根据最高的MCS能力被分为四个LOC (L-1到L-3).
- 分析了2016年至2022年期间接受CS治疗的成人患者 (ICD-10代码R57.0).
- 病因,管理和结果在LOC之间使用电子健康记录进行了比较.
主要成果:
- 较高的LOC中心患者数量较高,主要管理转移,而较低的LOC中心从急诊室接收的患者更多.
- 年轻患者和急性心肌梗塞 (AMI) -CS或急性心力衰竭 (AHF) -CS患者在较高的LOC中心更常见.
- 尽管患者群体和干预措施存在差异,但在LOC跨越多变量调整后,住院死亡率没有显著差异.
结论:
- 基于MCS能力的CS的LOC的务实分类可以根据患者人口统计,实践模式和结果来区分中心.
- 这种分类为未来的研究和结构化CS护理系统的开发提供了基础.
相关概念视频
Blood Pressure Imbalances and Circulatory Shock
784
Disorders affecting blood volume, vascular tone, or vascular function can disrupt vascular homeostasis, including conditions like hypertension, hemorrhage, and shock.
Blood Pressure: Hypertension and Hypotension
Normal blood pressure is 120/80 mm Hg. Elevated blood pressure is 120-129/under 80 mm Hg. Hypertension, warranting treatment at 130/80 mm Hg, is often asymptomatic and can lead to severe cardiovascular events, aneurysms, peripheral arterial disease, chronic renal disease, or cardiac...
Blood Pressure: Hypertension and Hypotension
Normal blood pressure is 120/80 mm Hg. Elevated blood pressure is 120-129/under 80 mm Hg. Hypertension, warranting treatment at 130/80 mm Hg, is often asymptomatic and can lead to severe cardiovascular events, aneurysms, peripheral arterial disease, chronic renal disease, or cardiac...
784
Pathophysiology of Heart Failure
1.6K
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
1.6K
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
436
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
436
Cardiac Catheterization IV: Nursing Management
25
Nursing responsibilities before cardiac catheterization include:Assess for allergies and establish baseline health status.Before cardiac catheterization, assess the patient for allergies to contrast dye. Perform a comprehensive baseline assessment, including vital signs, heart and breath sounds, and a neurovascular assessment of the extremities, noting distal pulses, skin color, and temperature. Instruct the patient to fast for 8-12 hours before the procedure. Evaluate baseline laboratory...
25
Traditional Level Of Health Care System
2.8K
The levels of care describe the services provided in the healthcare system. Accordingly, there are six levels of the traditional healthcare system in the US: preventive, primary, secondary, tertiary, restorative, and continuing healthcare. A nurse must understand how the healthcare industry organizes and provides services within these levels of care.
The preventive healthcare service includes tests for screening. Preventive health care services include identifying and reducing disease risk...
The preventive healthcare service includes tests for screening. Preventive health care services include identifying and reducing disease risk...
2.8K
Imbalances in Cardiac Output
1.4K
The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
1.4K


