对于患有危急心脏病的儿童进行高风险输出管准备测试
Chen Yun Goh1, Herng Lee Tan2, Yi-Jyun Ma2
1Respiratory Therapy Service, Division of Allied Health Specialties, KK Women's and Children's Hospital, Singapore goh.chen.yun@kkh.com.sg.
Respiratory care
|April 30, 2024
概括
在输管心脏病患者中实施高风险输管准备测试 (ERT) 协议,显著减少了输管前并发症. 这项质量改进计划表明,排气失败和需要呼吸辅助的复合结果较低.
科学领域:
- 关键护理医学 关键护理医学
- 心脏病学 心脏病学
- 呼吸系统疗法 呼吸系统疗法
背景情况:
- 包括自发呼吸试验 (SBT) 在内的协议化输出管准备测试 (ERT) 对输入管患者至关重要.
- 这项研究的重点是改善接受机械呼吸的心脏病患者的外抽术后结果.
研究的目的:
- 为了评估高风险ERT协议的有效性,除了用于直管心脏病患者的标准风险协议.
- 评估对输出管失败的影响以及需要输出管后呼吸支的需要.
主要方法:
- 一个质量改进项目,涉及213名心脏病患者.
- 实施标准风险ERT协议 (压力支持加PEEP),然后实施高风险ERT协议 (仅PEEP).
- 综合结果的比较,通风器的持续时间,以及在协议阶段之间使用呼吸辅助器.
主要成果:
- 高风险的ERT协议与排泄失败和救援非侵入性呼吸支持的复合结果的显著减少有关 (调整后的几率比率为0.20,P = .037).
- 没有观察到呼吸器持续时间的显著增加或计划的非侵入性呼吸辅助的使用.
- 虽然整体综合结果在各阶段都有下降趋势,但在调整后,只有高风险方案显示出统计学意义.
结论:
- 在心脏病患者中实施高风险的ERT协议,使得心脏病患者的输管治疗结果得到改善.
- 这些发现支持使用量身定制的高风险ERT协议,以优化机械通风后患者的康复.
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