在复杂肺炎的神经临界护理患者中应用两个排水角度:一个随机对照试验
Anna Zhao1, Huangrong Zeng1, Hui Yin1
1Department of Neurocritical Care Unit, Guangdong Sanjiu Brain Hospital, Guangzhou, Guangdong Province, China.
PeerJ
|March 4, 2024
概括
在患有肺炎的神经临界护理患者中,与平坦姿势相比,30°的头上倾斜姿势改善了临床肺部感染得分和无不良影响的氧化. 这一发现支持30°的头向上倾斜对于这些患者的肺部感染管理.
科学领域:
- 神经临界护理是指神经临界护理.
- 肺部医学 肺部医学
- 临界护理护理重症监护护理
背景情况:
- 内压升高 (ICP) 管理通常涉及头部升高,但由于潜在的二次脑损伤,倾斜或俯卧的位置存在争议.
- 管理肺炎神经临界患者需要仔细考虑定位,以平衡内压力和脑输液与呼吸需求.
- 临床肺感染评分 (CPIS) 是诊断和监测重症患者肺炎的验证工具.
研究的目的:
- 为了比较两个姿势排水姿势 (30°抬头倾斜与0°平头) 对复杂肺炎神经临床护理患者的预后的影响.
- 提供基于证据的建议,为在肺炎患者的神经临床护理单位选择最佳的姿势排水位置.
主要方法:
- 进行了一项前性随机对照研究,涉及62名患有复杂性肺炎 (CPIS ≥5) 的神经临床护理患者.
- 患者被随机分配到对照组 (0°头平) 和实验组 (30°头向上倾斜),两者都接受了人工呼吸道管理的捆绑护理.
- 基线特征与基线特征相匹配,通过比较CPIS和其他干预后治疗指标来评估护理干预的有效性.
主要成果:
- 组内分析显示,CPIS,动脉氧气压和氧化指数有显著改善,同时两组 procalcitonin 和吸入风险得分的趋势在下降.
- 组间比较显示,干预前或干预后的任何指标都没有显著差异,这表明两种立场在各自组内都是有效的.
- 对于任何姿势排水位置都没有报告任何不良影响.
结论:
- 无论是30°的头向上倾斜和0°的头平的姿势排水位置都有效地改善了CPIS和肺炎神经临界患者的氧化,没有任何不良影响.
- 建议在肺炎神经临界患者的姿势排水中使用30°的头向上倾斜位置,强调良好的集中肺炎感染护理.
- 进一步的研究可能会探索特定神经临界条件的最佳床头角度,以最大限度地提高益处并最大限度地降低风险.
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