为心血管手术患者实施手术前贫血优化协议:质量改进项目
Ashley Rittenhouse1, Marilyn Ostendorf2, Chanice Johns3
1Ashley Rittenhouse is a critical care registered nurse, Franciscan Health Indianapolis, Indianapolis, Indiana.
Critical care nurse
|May 31, 2024
概括
贫血优化方案可以改善心脏手术患者的治疗结果. 实施标准化方案减少了红细胞输血,并可能降低术后并发症的风险,如急性损伤.
科学领域:
- 心脏病学 心脏病学
- 血液学 血液学 血液学
- 在外科手术期间的医学.
背景情况:
- 心脏手术患者的贫血与更糟糕的结果有关.
- 手术后增强恢复 (ERAS) 准则建议进行手术前优化,包括贫血治疗.
- 在心胸外科手术组的标准化手术前贫血管理中存在差距.
研究的目的:
- 开发和实施一个标准化的贫血优化协议,为外科心脏手术患者.
- 评估该方案对二次结果的影响,包括输血率和术后并发症.
主要方法:
- 使用最好的证据和来自心脏外科和血液学专家的专家共识,制定了一项协议.
- 数据被追溯分析,以评估协议使用与患者结果之间的关系.
- 该协议被整合到心脏手术患者的标准咨询流程中.
主要成果:
- 42%的贫血患者通过该协议接受干预.
- 协议组显示了较低的平均输血需求 (1.9 U vs 3.5 U/患者).
- 在患有急性损伤的患者中,协议组的平均肌素增加较小 (0.65 mg/dL vs 1.52 mg/dL).
结论:
- 手术前的贫血管理方案可以减轻与心脏手术相关的风险.
- 协议的实施表明,红细胞输血量减少,急性损伤的严重程度降低.
- 建议在心脏手术患者中继续使用贫血优化方案.
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