强化主导的超声波引导的皮肤通道气管切除术:一个第四阶段的队列研究
Pedro Fortes Osório Bustamante1, Bruno Adler Maccagnan Pinheiro Besen1, Amanda Pinto Botêga1
1Intensive Care Unit, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo - São Paulo (SP), Brazil.
Critical care science
|January 24, 2024
概括
强化治疗师带领的超声波引导的皮肤通道气管切除术是重症监护病房中可行的床边手术. 结果和并发症与文献相似,突出了对潜在风险的密集意识的需要.
科学领域:
- 关键护理医学 关键护理医学
- 手术手术手术手术手术手术手术手术手术手术
- 医疗成像医学成像
背景情况:
- 穿皮扩张气管切除术 (PDT) 是重症监护病房 (ICU) 中常见的一种手术.
- 超声指导越来越多地被用于提高PDT的安全性和有效性.
- 在实践中,对强化治疗师领导的超声波引导的PDT实施的真实数据至关重要.
研究的目的:
- 在一个大型的,现实世界的队列中,评估专家主导的超声波导向皮肤通气管切除术 (UG-PDT) 的可行性和结果.
- 识别在受控临床试验中通常没有观察到的程序风险和并发症.
主要方法:
- 进行了第四阶段,单中心,前性队列研究.
- 这项研究包括从2017年9月到2021年12月在三个重症监护室接受强化治疗师领导的UG-PDT的患者.
- 收集的数据包括患者人口统计数据,气管切除术的指示,手术细节,并发症和死亡率.
主要成果:
- 在4,810名ICU入院患者中,287名患者接受了气管切除术,其中227名患者由ICU团队在床边进行.
- 主要症状是神经损伤或呼吸道保护,从输入管到气管切除术的中位时间为14天.
- 在29.5%的手术中出现并发症,最常见的是血液动力学不稳定性和意外的输出管;严重的并发症很少见. 在ICU和医院的死亡率分别为29.1%和43.6%.
结论:
- 在常规的临床实践中,专家主导的UG-PDT是可行的和安全的,其结果与已发表的文献相似.
- 密集者可以在培训期间掌握这种技术.
- 意识到潜在的并发症对于优化程序安全和患者结果至关重要.
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