临床变量的实用性,以决定帕拉奎特中毒的息治疗:一项回顾性研究
Shwethapriya Rao1, Sagar Shanmukhappa Maddani1, Souvik Chaudhuri1
1Department of Critical Care Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India.
概括
早期息护理转诊对于帕奎特中毒 (PP) 患者至关重要. 低的PaO2/FiO2比率和高的SOFA得分预测死亡率,表明需要及时干预.
科学领域:
- 关键护理医学 关键护理医学
- 毒理学 毒理学 毒理学
- 抚慰性护理是一种缓解性护理.
背景情况:
- 帕奎特中毒 (PP) 的死亡率很高,类似于晚期癌症.
- 息治疗在重症PP患者中使用不足.
- 确定缓解护理转诊的早期触发因素至关重要.
研究的目的:
- 为了确定帕奎特中毒患者死亡率的临床预测因素.
- 在重症PP患者中确定早期息护理转诊的触发因素.
主要方法:
- 追溯审核了108名帕拉克瓦特中毒患者的医疗记录.
- 分析住院48小时内死亡率的预测因素和ICU入院24小时内死亡率.
- 使用的PaO2/FiO2比率和顺序器官衰竭评估 (SOFA) 成绩.
主要成果:
- 在分析的84个记录中,63.1%的记录已经过期.
- 最低的PaO2/FiO2 ≤197 在48小时内预测死亡率 (AUC 0.924,灵敏度97%).
- 在ICU入院24小时内,SOFA得分≥9预测死亡率 (AUC0.980,灵敏度91%).
- 所有53名最终死亡的患者都需要机械通风.
结论:
- 低的PaO2/FiO2 (≤197) 和高的SOFA得分 (≥9) 是PP中死亡率的关键预测因素.
- 这些临床变量可以作为早期息治疗转诊的触发因素.
- 早期的息治疗可以改善重症PP患者的治疗结果.
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