在意大利心脏重症监护室网络中过渡到息治疗
Alice Sacco1, Matteo Pagnesi2, Simone Frea3
1Alice Sacco is a physician, Cardiac Intensive Care Unit, De Gasperis Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
概括
息治疗很少被整合到急性不补偿性心力衰竭患者的生命终结管理中. 这项研究强调了需要在心脏重症监护病房早期参与息治疗,以改善患者和家庭的支持.
科学领域:
- 心脏病学 心脏病学
- 抚慰性护理是一种缓解性护理.
- 密集护理医学 密集护理医学
背景情况:
- 在心脏重症监护室 (CICU) 治疗急性不补偿性心力衰竭 (ADHF) 患者的终身护理往往是激进的.
- 息治疗团队经常在急症监护室 (CICU) 的设置中迟到或根本没有参与.
研究的目的:
- 评估目前意大利中心的缓解护理和生命终端实践,用于因ADHF引起心脏性休克的患者.
- 评估息治疗的整合和植入式心脏转换器-除器 (ICD) 的停用.
主要方法:
- 在12个意大利中心使用基于调查的方法.
- 从AltShock-2注册表收集数据,分析了153名因ADHF而患有心脏性休克的患者.
- 专注于早期息护理咨询和ICD停用实践.
主要成果:
- "不复苏"命令仅在42%的中心存在.
- 息护理团队只参与了13.7%的病例.
- 在死亡的ICD患者中,有35%的人失活了除器;家庭息治疗支持了一次ICD失活.
结论:
- 治疗限制的做法,如ICD禁用,在参与的意大利中心中不是标准的.
- 与重症监护同时整合息护理对于解决患者和家庭需求至关重要.
- 在ADHF管理中及时整合息护理的巨大未满足需求.
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