开发和验证用于持续植物状态的个体中气管切除术脱的诺姆图:一项多中心研究
Hongji Zeng1, Xi Zeng2, Nanxi Liu3
1School of Public Health, Zhengzhou University, No. 100 Science Avenue, Zhengzhou City, Henan Province 450000, China.
Annals of physical and rehabilitation medicine
|June 3, 2024
概括
在持续植物状态 (PVS) 患者中预测气管切除术断管是至关重要的. 这项研究确定了关键的风险和保护因素,并开发了一个名谱来帮助治疗决策并减少脱失败.
科学领域:
- 医学研究 医学研究
- 临床医学 临床医学
- 康复 康复 康复 康复
背景情况:
- 在持久植物状态 (PVS) 患者的脱化带来了重大挑战.
- 在这个人群中确定成功脱的预测因素至关重要.
研究的目的:
- 确定PVS患者中气管切除术脱管结局的预测因素.
- 在PVS患者中开发一个可预测的断管成功的预测名录.
主要方法:
- 追溯招募872名经过气管切除术的PVS患者.
- 数据分为培训 (70%) 和验证 (30%) 集.
- 多变量回归,5倍交叉验证,ROC曲线和DCA用于模型验证.
主要成果:
- 确定了脱管失败的危险因素:长时间的气管切除术,肺部感染,低蛋白血症,缺乏站立训练,异常的吞反射,机械呼吸,延长ICU停留时间和年龄较大.
- 确定的保护因素:口腔养,足够的站立训练,私人护理人员和更短的ICU时间.
- 开发的诺米图表显示出很好的预测准确度 (AUC 0.744,C指数 0.784/0.768).
结论:
- 一个经过验证的诺姆图可以帮助临床医生定制治疗策略.
- 诺米图的目的是通过降低脱失败率来改善患者的治疗结果.
相关概念视频
Tracheostomy Decannulation
148
Tracheostomy decannulation is a significant milestone in the liberation of mechanically ventilated patients. Despite its importance, there is no universally accepted protocol for this procedure. This demands an evidence-based, individualized approach.
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...
148
Tracheostomy Care I: Pre-procedural Steps
175
A tracheostomy is a surgical technique that involves making an incision in the neck to provide access to the trachea. It is frequently used in medical conditions such as airway obstruction and prolonged mechanical ventilation. Effective nursing management is crucial for the long-term success of a tracheostomy.
Required Equipment
The equipment necessary for tracheostomy care includes:
Required Equipment
The equipment necessary for tracheostomy care includes:
175
Oxygen Delivering System III: Tracheostomy and T-piece
791
Oxygen delivery is critical in clinical care, especially for patients with respiratory disorders or those undergoing surgical procedures. Various systems, such as tracheostomy and the T-piece, deliver oxygen to the lungs, ensuring adequate arterial oxygenation.
Tracheostomy
A tracheostomy is a surgically created opening (stoma) in the anterior part of the trachea. It is used to establish a patient airway, bypass an upper airway obstruction, simplify the removal of secretions, permit long-term...
Tracheostomy
A tracheostomy is a surgically created opening (stoma) in the anterior part of the trachea. It is used to establish a patient airway, bypass an upper airway obstruction, simplify the removal of secretions, permit long-term...
791
Oxygen Delivering System II: Venturi Mask and Transtracheal Oxygen
513
Oxygen therapy is a pivotal aspect of medical care, particularly for patients with respiratory ailments. Two prominent oxygen-delivering systems include the Venturi mask and the transtracheal oxygen catheter.
Venturi Mask
The Venturi mask, named after the Venturi effect, is designed to deliver precise oxygen concentrations. It consists of a large tube with an oxygen inlet that narrows down, causing a pressure drop that pulls air in through adjustable side ports. The mask is a lightweight,...
Venturi Mask
The Venturi mask, named after the Venturi effect, is designed to deliver precise oxygen concentrations. It consists of a large tube with an oxygen inlet that narrows down, causing a pressure drop that pulls air in through adjustable side ports. The mask is a lightweight,...
513
Tracheostomy Suctioning I: Pre-Procedural Steps
512
Tracheostomy suctioning is a critical procedure healthcare professionals perform to maintain a patent airway in patients with a tracheostomy tube. This procedure is necessary when secretions accumulate in the airway, causing respiratory distress. Here is a step-wise procedural guide for performing tracheostomy suctioning using an open system.
Equipment Required
First, gather all necessary equipment: a sterile suction catheter, a sterile disposable container, sterile gloves, a towel or...
Equipment Required
First, gather all necessary equipment: a sterile suction catheter, a sterile disposable container, sterile gloves, a towel or...
512
Tracheostomy: Procedure and Tubes
518
A tracheostomy is a surgical procedure that creates an artificial opening into the trachea, typically at the second or third cartilaginous ring level. This opening allows the insertion of a tracheostomy tube, which can replace an endotracheal tube, provide mechanical ventilation, bypass an upper airway obstruction, or remove accumulated tracheobronchial secretions.
Tracheostomy tubes can be made of semiflexible plastic (polyurethane or silicone), rigid plastic, or metal, and they come in...
Tracheostomy tubes can be made of semiflexible plastic (polyurethane or silicone), rigid plastic, or metal, and they come in...
518


