创伤患者在医院前紧急麻醉后的临界高血压:一个多中心的回顾性观察研究
Liam Sagi1, James Price2,3, Kate Lachowycz2
1Department of Research, Audit, Innovation, and Development, East Anglian Air Ambulance, Norwich, UK. Liam.sagi@eaaa.org.uk.
Scandinavian journal of trauma, resuscitation and emergency medicine
|December 21, 2023
概括
在创伤患者的医院前紧急麻醉 (PHEA) 可以导致严重的高血压. 老年,较低的GCS运动分数,较高的PHEA前SBP和多次输管试验是关键的危险因素.
科学领域:
- 紧急医疗 紧急医疗
- 创伤外科 手术 创伤外科
- 麻醉学 麻醉学
背景情况:
- 创伤患者的临界高血压与较高的死亡率相关.
- 医院前应急麻醉 (PHEA) 适用于10%的严重受伤患者.
- 优化生理参数对于减少二次脑损伤至关重要.
研究的目的:
- 在创伤患者中确定PHEA后与临界高血压相关的因素.
- 分析来自三个直升机紧急医疗服务 (HEMS) 组织的大型区域数据集.
主要方法:
- 多中心回顾性观察性研究 (2015-2022年).
- 包括接受PHEA的成年创伤患者.
- 临界高血压定义为SBP>180mmHg或PHEA后增加>10%.
- 后勤回归分析以确定决定因素.
主要成果:
- 在1355名分析患者中,11.9%的患者经历了PHEA后的临界高血压.
- 独立预测因素包括年龄的增加,PHEA前GCS运动得分较低 (4-5),PHEA前SBP>140mmHg,以及多次输管尝试.
结论:
- 创伤患者的PHEA存在血液动力学波动的风险,特别是严重的高血压.
- 年龄,GCS运动分数,PHEA前的SBP和输管尝试是PHEA后临界高血压的显著独立预测因素.
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