在美国儿童医院治疗状细胞病的氧和值
Aravind Yadav1, Faryal Munir2, Kok Hoe Chan3
1Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston (UTHealth Houston) and Children's Memorial Hermann Hospital, Houston, Texas, USA.
在患有状细胞疾病 (SCD) 的儿童中,氧和度 (SpO2) 的临床指导方针差异很大. 许多医院不遵循国家建议,可能导致急性事件期间SCD儿童的氧气治疗不足.
科学领域:
- 儿科血液学 儿科血液学
- 关键护理医学 关键护理医学
- 临床实践指南 临床实践指南
背景情况:
- 适当的氧和 (SpO2) 对于控制状细胞疾病 (SCD) 至关重要.
- 患有SCD的儿童容易发生隐性低氧化,因此需要明确的SpO2管理协议.
- 了解当前的SpO2值实践可以揭示在这个人群中实现最佳氧气治疗的障碍.
研究的目的:
- 为了研究在美国儿童医院中用于管理急性SCD事件的临床算法中使用的SpO2切断水平.
- 评估这些SpO2值与已建立的国家指南 (SpO2>95%) 的一致性.
主要方法:
- 在SCD中管理血管封闭性危机 (VOC) 和急性胸部综合征 (ACS) 的临床途径和算法.
- 从美国各地的大型儿童医院收集数据.
主要成果:
- 45%的受访医院有可用的临床算法用于VOC和ACS管理.
- 观察到SpO2截止值水平的显著变化,范围从≥90%到≥95%.
- 只有5%的医院遵守国家SpO2指南,南方和中西部的算法流行率更高.
结论:
- 不一致的临床算法和VOC和ACS的氧气值存在于美国儿童医院.
- 患有SCD的儿童在急性,严重事件期间可能面临接受不足氧气治疗的风险.
- 需要对SpO2管理协议进行标准化,以确保对儿科SCD患者的最佳护理.
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Published on: March 14, 2017
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