急性疾病机械通风成年患者的呼吸障碍:一个ERS/ESICM声明
Alexandre Demoule1,2, Maxens Decavele3,4, Massimo Antonelli5
1Service de Médecine Intensive-Réanimation, Département R3S, AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, Site Pitié-Salpêtrière, 75013, Paris, France. alexandre.demoule@aphp.fr.
Intensive care medicine
|February 23, 2024
概括
机械通风器上的重症患者经常经历严重的呼吸不良,是一种与原始恐惧相似的痛苦感觉. 本次审查强调迫切需要普遍识别,预防和管理重症监护室 (ICU) 呼吸道疾病的策略.
科学领域:
- 关键护理医学 关键护理医学
- 呼吸系统医学 呼吸系统医学
- 患者体验 患者体验
背景情况:
- 呼吸不全 (呼吸短促) 是一种非常令人痛苦的症状,影响了重症监护室 (ICU) 机械通风成年患者的约40%.
- 在ICU患者中,呼吸障碍的强度可能是严重的,会影响他们的生活质量,并可能引起原始恐惧反应,对一些人来说超过疼痛的痛苦.
- 尽管呼吸障碍在机械通风患者中的流行和严重程度,但与疼痛管理相比,呼吸障碍得到的关注不足,这凸显了重症监护实践中的重大差距.
研究的目的:
- 审查关于严重病的机械通风成年人呼吸障碍的文献和当前实践.
- 涵盖呼吸障碍的定义,病理生理学,流行病学,影响,检测和管理.
- 突出需要加强对ICU中呼吸道疾病的关注.
主要方法:
- 文献综述和对当前实践的分析.
- 综合有关呼吸障碍患病率,重要性,诊断和管理的信息.
- 欧洲呼吸学会 (ERS) 与欧洲重症监护医学学会 (ESICM) 之间的合作.
主要成果:
- 机械通风患者由于生理状态和通风而面临呼吸障碍的高风险.
- 患者在发出痛苦信号时面临障碍,需要主动识别.
- 呼吸障碍的强度可能很高,在0-100毫米视觉模拟尺度上平均为45毫米.
结论:
- 呼吸障碍必须在所有患者中被普遍识别,预防和缓解.
- 应对这种临床挑战需要教育,培训和护理人员和患者的参与.
- 有必要改善ICU患者的呼吸道疾病的识别和管理,这与现有的重点是疼痛不同.
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