在计划性输出管后,在48小时内重新输入管对危急病患者的死亡率的影响
Michelli Marcela Dadam1, Aline Braz Pereira1, Mariane Ribeiro Cardoso1
1The Hospital Municipal São José, Joinville, Santa Catarina, Brazil.
Respiratory care
|May 21, 2024
概括
计划性输出管后的重新输入管显著增加了危急病患者的死亡率. 这项研究强调了在48小时内重新输入管所带来的风险,强调了需要谨慎的输出管策略的需要.
科学领域:
- 关键护理医学 关键护理医学
- 呼吸系统疗法 呼吸系统疗法
- 临床结果研究研究
背景情况:
- 计划性输出管后的再输入管发生在2-30%的病例中.
- 这种程序与增加的死亡率,长时间的机械通风和更高的肺炎率有关.
- 了解再灌输的影响对于改善患者的治疗结果至关重要.
研究的目的:
- 为了评估48小时内重新输管对计划输管后死亡率的影响.
- 为了确定与急性病患者的死亡率相关的独立因素.
主要方法:
- 一个多中心随机对照试验的二次分析.
- 包括12小时以上侵袭性机械通风的成年患者.
- 使用后勤回归,比较了输出失败 (在48小时内重新输入) 和输出成功组之间的结果.
主要成果:
- 336名受试者中有15.4%的输出管失败,大多数重新输入管发生在12-24小时之间.
- 输出失败组的死亡率明显高 (ICU:32.6%与6.6%相比;住院:42.3%与14.0%相比).
- 在48小时内重新输液,独立地与ICU和住院死亡率的增加有关.
结论:
- 计划的输出管后48小时内重新输入管是死亡率的重要独立预测指标.
- 需要重新输管的重症患者面临着更高的死亡风险.
- 脱口术后的救援非侵入性通风也与住院死亡率有关.
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