在手术室到ICU过渡期间调整风扇参数和28天死亡率
Dario von Wedel1,2, Simone Redaelli1,2,3, Aiman Suleiman1,2,4
1Department of Anesthesia, Critical Care and Pain Medicine.
American journal of respiratory and critical care medicine
|January 8, 2024
概括
在手术室 (OR) 到重症监护室 (ICU) 过渡期间调整通风器可以增加机械功率 (MP). 在此过渡期间更高的MP与机械通风手术患者28天死亡风险的增加有关.
科学领域:
- 关键护理医学 关键护理医学
- 麻醉学 麻醉学
- 呼吸系统生理学 呼吸系统生理学
背景情况:
- 肺部保护性机械通风策略在OR和ICU中建立.
- 风扇管理实践在OR和ICU设置之间往往有所不同.
- 这导致OR-to-ICU患者过渡期间的参数调整.
研究的目的:
- 分析从OR转移到ICU的手术患者的呼吸器参数调整.
- 评估这些调整与28天死亡率之间的关联.
主要方法:
- 从2008年到2022年对医院注册表的回顾性分析.
- 包括在ICU中接受全身麻醉并继续机械通风的患者.
- 风扇参数 (潮体积,驱动压力,呼吸率,机械功率) 在转换前后进行评估.
主要成果:
- 潮体积和驱动压力下降,而呼吸率在过渡后增加.
- 在ICU设置中,整体机械功率 (MP) 略有增加.
- 增加的MP与较高的28天死亡率显著相关 (aOR 1.10; aRD 0.7%).
结论:
- 在OR-to-ICU过渡期间的风扇调整可能会导致机械功率增加.
- 在这个关键时期,机械功率的增加与患者死亡率的增加有关.
- 在护理环境中标准化呼吸机管理可能会改善患者的治疗结果.
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