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通过使用咳峰值呼气流进行咳力评估来调查重新灌输的风险:单中心观察试点研究
Kenya Murata1, Keiichiro Shimoyama2, Takeshi Tsuruya3
1Department of Nursing, Tokyo Medical University Hospital, Tokyo, Japan. jpradish920@gmail.com.
BMC pulmonary medicine
|May 7, 2024
概括
咳高峰呼气流 (CPEF) 可以预测 extubated 患者的 reintubation 风险. 低于60L/分钟的CPEF表明由于咳强度减弱,重新灌输的风险更高.
科学领域:
- 关键护理医学 关键护理医学
- 呼吸系统生理学 呼吸系统生理学
- 肺部康复治疗 肺部康复治疗
背景情况:
- 缺乏客观指标来评估抽管患者咳的强度.
- 评估咳的强度对于防止重新输管至关重要.
- 咳强度下降是重症患者重新输管的主要原因.
研究的目的:
- 评估咳峰值呼气流 (CPEF) 作为重新输管风险的预测指标.
- 为了确定CPEF是否能够识别出咳强度不足的患者.
- 为了建立一个CPEF值来预测由于咳受损而导致的再灌输.
主要方法:
- 对76名接受机械通风24小时以上的患者进行了回顾性队列研究.
- 在成功的输出管和重新输入管组之间的CPEF比较.
- 使用单变量和多变量模型分析CPEF,年龄和通风持续时间.
主要成果:
- 与成功脱管组 (90.7 L/min) 相比,在再输管组 (57.2 L/min) 中的CPEF显著较低.
- 多变量分析证实CPEF是重新输管的重要预测因素,独立于年龄和通风持续时间.
- 60L/分钟的CPEF截止值显示出高灵敏度 (78.5%) 和特异性 (90.9%) 预测重新输管.
结论:
- CPEF 是一个有价值的,客观的指标,用于预测 extubated 患者的再灌输风险.
- 60L/分钟的CPEF值有效地识别了由于咳强度降低而面临重新灌管风险的患者.
- 实施CPEF测量可以帮助临床决策,以预防输出管和重新输入管.
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