在Nil Per Os状态和接受手术的输管患者之间存在关联
Margaret Siu1, Aixa Perez Coulter1, Heather M Grant1
1Department of Surgery, University of Massachusetts Chan Medical School-Baystate, Springfield, Massachusetts.
The Journal of surgical research
|November 29, 2023
概括
长期无人机 (NPO) 状态,或保持肠道养,在接受手术的急症患者中没有增加呼吸道并发症. 这些发现挑战了对重症手术患者手术前禁食的常见做法.
科学领域:
- 关键护理医学 关键护理医学
- 手术营养是指手术营养.
- 呼吸系统生理学 呼吸系统生理学
背景情况:
- 营养支持对于患者的结果至关重要.
- 危急病患者在手术前往往会经历长时间的无人 (NPO) 状态.
- 目前的做法可能超过推的禁食指南.
研究的目的:
- 为了研究无人机 (NPO) 状态的持续时间和呼吸系统结果之间的关系.
- 根据手术前的NPO持续时间,比较输管,重症患者的不良呼吸事件.
- 评估在重症监护病房中遵守禁食指南的情况.
主要方法:
- 对接受手术 (2016-2018) 的被直管,危急病患者的回顾性分析.
- 与NPO ≥6小时 (NPO组) 和NPO <6小时 (非NPO组) 的患者之间的呼吸结果的比较.
- 纳入标准:被直管,需要手术干预的危急病患者.
主要成果:
- 在吸入 (5.8%对7.3%),脱 (16.3%对14.6%),肺炎 (18.3%对19.8%) 或再输管率 (13.5%对16.7%) 中,两组之间没有显著差异.
- 与非NPO组 (1.0小时) 相比,NPO组 (13.0小时) 的中位数NPO持续时间明显更长.
- 所有呼吸道结果的P值都不显著 (P > 0.05).
结论:
- 没有观察到输入管的危急病患者的呼吸系统不良事件的风险增加,他们保持零每次 (NPO) ≥6小时,而<6小时.
- 患者经常经历过超过美国麻醉学会6小时建议的NPO持续时间.
- 研究结果表明,目前的NPO实践可能会不必要地延长,没有明显的呼吸道益处.
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