在体外心肺复苏中的"周末效应"
Kinam Shin1, Won Chul Cho2, Pil Je Kang1
1Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Journal of chest surgery
|February 19, 2024
概括
周末效应在体外心肺复苏 (ECPR) 中显示,在非工作时间内,ECMO团队的到达时间更长. 在夜间,ECMO的插入时间也更长,这表明需要专门的培训.
科学领域:
- 心脏病学 心脏病学
- 紧急医疗 紧急医疗
- 关键的护理关键的护理
背景情况:
- 这是一个很棒的节目,这是一个很棒的节目.
- 周末效应是周末的效应.
- 是一种公认的现象,影响了各种医疗学科的医疗保健结果.
- 它在体外心肺复苏 (ECPR) 中的存在需要调查,以优化非工作时间的患者护理.
研究的目的:
- 为了调查该项目的影响.
- 周末效应是周末的效应.
- 关于体外心肺复苏 (ECPR) 的结果.
- 为了比较ECPR程序时间和正常时间和非正常时间之间的成功率.
主要方法:
- 在2018年1月至2020年12月期间,对159名因心脏骤停而接受静脉动脉外体膜氧化 (ECMO) 治疗的患者进行了回顾性分析.
- 在三个时间段中比较ECMO准备时间,成功断奶率和住院死亡率:白天 (周日早上7点至晚上7点),夜间 (周日晚上7点至早上7点) 和周末/假日 (周五晚上7点至周一早上7点).
主要成果:
- 从心脏骤停识别到ECMO团队到达的时间在休息时间 (周末:15.0分钟) 与白天 (10.0分钟;p=0.064) 相比,显着更长.
- 团队到达后的ECMO启动时间在夜间 (18.5分钟) 与白天 (13.0分钟;p=0.028) 相比较长.
- 在不同时间段成功的ECMO断奶率中没有发现显著差异 (白天:48.3%,夜间:39.5%,周末:36.1%;p=0.375).
结论:
- 在工作时间外,特别是在周末,ECPR团队的到达时间会延长.
- 在夜班,ECMO插入程序需要更多的时间.
- 调查结果强调了需要加强决策培训和新兴的ECMO插入协议的必要性.
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