在入住外科重症监护病房的患者中,遵守肺部保护性机械通风,以及与此相关的死亡率增加
Annop Piriyapatsom1, Ajana Trisukhonth1, Ornin Chintabanyat1
1Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, 10700, Thailand.
Heliyon
|February 26, 2024
概括
在手术ICU中,对肺部保护性通风 (LPV) 的遵守率为36.9%,身高是关键因素. 这一策略与更高的90天死亡率有关,需要进一步调查.
科学领域:
- 临界护理医学 临界护理医学
- 呼吸系统疗法 呼吸系统疗法
- 机械通风机械通风机械通风
背景情况:
- 肺部保护性通风 (LPV) 是机械通风患者的标准.
- 文献表明,对LPV的坚持率约为40%.
- 了解手术ICU中的LPV坚持是至关重要的.
研究的目的:
- 确定手术重症监护室 (SICU) 中对LPV策略的坚持率.
- 确定与LPV坚持相关的因素.
- 检查LPV坚持和临床结果之间的关系.
主要方法:
- 在高等大学医院SICU进行前性观察研究 (2018年4月 - 2019年2月).
- 包括306名需要机械通风12小时以上的成年患者.
- 定义的LPV为潮体积≤8毫升/公斤PBW和PEEP≥5厘米H2O.
主要成果:
- 对LPV战略的坚持率为36.9%.
- 患者身高是与LPV坚持相关的唯一显著因素 (或每厘米1.10).
- 这种LPV策略与90天死亡率的增加有关 (HR 1.73).
结论:
- 在SICU环境中遵守LPV是温和的.
- LPV与死亡率增加之间的关联需要进一步研究.
- 调查LPV是否是严重性标志物或死亡原因.
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