调查泰国医生在儿科败血症休克的实践
Sirapoom Niamsanit1, Teerapat Saengthongpitag2, Rattapon Uppala1
1Department of Pediatrics, Faculty of Medicine, Khon Kaen University, 123 Mittraphap Road, Muang, Khon Kaen 40002, Thailand.
Children (Basel, Switzerland)
|May 25, 2024
概括
泰国医生在儿科败血症管理方面表现出显著的知识差距,特别是关于液体复苏和冷震的血管活性剂. 建议定期进行培训,以提高对临床指南的遵守.
科学领域:
- 儿科急救医学 儿科急救医学
- 临床实践指南 临床实践指南
- 败血症管理管理
背景情况:
- 儿童败血症的有效应急管理至关重要.
- 这项研究评估了泰国医生对当前儿科败血症临床实践指南的理解和应用.
- 研究了知识差距和遵守问题.
研究的目的:
- 评估泰国医生在儿科败血症紧急管理方面的知识差距.
- 评估泰国医生遵守目前的败血症临床实践指南.
- 确定影响儿科败血症休克管理指南决策的因素.
主要方法:
- 在2019年3月至4月期间,使用在线问卷进行了跨部门调查.
- 366名泰国医生,主要是全科医生,参与了调查.
- 收集了有关败血症管理实践的数据,包括液体复苏和血管活性剂选择.
主要成果:
- 虽然83.9%的人在败血症查后15分钟内开始医生评估,但只有56.3%的人遵循了指导方针推的液体加载剂量 (20毫升/公斤).
- 在热冲击中,第一种血管活性剂 (诺阿皮内林) 的准则遵守率为74.3%,但在冷冲击中 (上腺素) 的准则遵守率显著下降,为36.2%.
- 儿科医生在初始液体复苏和冷冲击血管活性剂方面表现出比全科医生更好的知识 (p < 0.001). 专家培训和败血症管理认证与遵守指南有关,而超过10年的经验与相反相关.
结论:
- 泰国临床医生对儿科败血症治疗标准表现出不熟悉,特别是关于早期液体复苏体积和适合寒冷休克的血管活性药物.
- 一般医生和儿科医生之间存在着重要的知识和实践差异.
- 建议定期授权关于儿科败血症管理的培训课程,以加强对指导方针的遵守.
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