机械通风COVID-19患者的压力损伤使用不同的倾斜定位技术 - 一项前性观察研究
Cara Woolger1, Thomas Rollinson2, Fiona Oliphant1
1Department of Intensive Care, Austin Hospital, 145 Studley Road, Heidelberg, Victoria, Australia.
Intensive & critical care nursing
|January 12, 2024
概括
机械通风COVID-19患者的游泳者位置方法导致压力损伤 (PIs) 比面向下方法少. 大多数PI是轻微的,并通过医院出院治愈.
科学领域:
- 关键护理医学 关键护理医学
- 肺部病理学 肺部病理学
- 患者安全 患者安全
背景情况:
- 机械通风的COVID-19患者通常需要倾斜的位置来改善氧化.
- 压力损伤 (PIs) 是躺卧时常见的并发症.
- 不同的倾斜定位技术可能会影响PI发生率.
研究的目的:
- 为了比较压力损伤 (PIs) 的发生率和分布,两种倾斜定位方法:面向下和游泳者位置.
- 为了确定PI在重症监护室 (ICU) 和医院出院的患病率.
主要方法:
- 在四级ICU中进行的前性观察研究,涉及COVID-19相关的急性肺损伤的成年患者.
- 在ICU停留期间和退院时的PI发病率和解剖分布的比较:面向下方的位置与游泳者的位置.
- 在2021年9月至2022年2月期间,研究了63名患者的206次易患病例.
主要成果:
- 与游泳者位置组 (45%) (p=0.02) 相比,面向下组的PI发病率显著更高 (76%).
- 面向下定位与每名患者更多的PI相关 (中位数为1比0,p=0.04) 和更高的面部PI率 (p=0.002).
- 超过80%的PI是第1或第2阶段;29%通过ICU出院治愈,73%通过医院出院.
结论:
- 游泳者位置表明压力伤害的发生率明显低于面向下方的方法.
- 这些发现支持当前的指导方针,建议在机械通风COVID-19患者的游泳者位置.
- 医院出院时PIs的低患病率表明有效的管理策略.
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