在创伤患者中预测第一通输管失败的预测因素
Katherine Kilkenny1, Shea McGrinder1, Michael J Najac2
1School of Medicine, New York Medical College, Valhalla, NY, USA.
International journal of general medicine
|March 11, 2024
概括
压缩性血压升高是创伤患者多次输管试验的关键预测因素. 对这些患者的批判性评估可能会降低新出现的气管管道输管过程中的风险.
科学领域:
- 紧急医疗 紧急医疗
- 创伤外科 手术 创伤外科
- 关键的护理关键的护理
背景情况:
- 多次输内管试验 (MIA) 与创伤患者的不良结果有关.
- 之前的研究已经确定了呼吸道困难的解剖学风险因素,但对创伤中MIA的预测因素的理解较少.
研究的目的:
- 在创伤患者接受突发气管输管 (ETI) 时,识别多次输管尝试 (MIA) 的风险因素.
- 评估二次结果,包括死亡率,ICU入院和长时间通风.
主要方法:
- 在1级创伤中心对174名需要ETI的成年创伤患者的回顾性研究 (2019年1月至2022年12月).
- 对并发症,人口统计,生命体征,输管特征和结果的分析.
- 多变量逻辑回归用于识别MIA的独立预测因子 (p≤0.05).
主要成果:
- 14.9%的患者需要MIA.
- 没有发现MIA和患者人口统计,BMI,种族,损伤机制或身体区域之间有显著的关联.
- 压缩性血压升高 (SBP) 是MIA的一个显著的单变性预测因子 (p=0.019).
- 升高的SBP独立预测了MIA (aOR为1.03,95% CI为1.01-1.06,p<0.015).
结论:
- 压缩性血压升高是创伤患者多次输管试验的重要预测因素.
- 针对创伤患者的高SBP的有针对性的批判性评估可以减轻与多次输管试验相关的风险.
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