在机械通风期间静脉输入阿片类药物,并在出院后使用
Laura C Myers1,2, Lauren Soltesz1,2, Nicholas Bosch3
1The Permanente Medical Group, Kaiser Permanente Northern California, Oakland.
JAMA network open
|June 14, 2024
概括
机械通风期间的阿片类药物剂量与住院后阿片类药物处方和持续使用的更高率有关. 需要进一步的研究,以探索在机械通风患者中降低阿片类药物给药的策略.
科学领域:
- 关键护理医学 关键护理医学
- 药理学 药理学是指药理学的学科.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 目前的指导方针建议在机械通风期间进行镇静,首先采取镇痛方法.
- 机械呼吸内阿片类药物暴露对出院后结果的长期影响仍然不清楚.
研究的目的:
- 调查在机械通风过程中给予的静脉注射阿片类药物剂量与医院出院后随后的阿片类药物相关结果之间的关联.
- 专注于经历急性呼吸衰竭的医疗 (非手术) 患者.
主要方法:
- 从21家医院 (2012-2019) 的6746名成年患者进行了回顾性队列研究.
- 患者因急性呼吸衰竭而接受机械通风24小时以上,并幸存住院治疗.
- 片类药物暴露被分类为通风期间每日静脉注射中位数芬太尼尔相当量的三分之一.
主要成果:
- 机械通风期间每天服用较高的阿片类药物剂量与在出院后一年内填补阿片类药物处方的可能性增加有关.
- 接受更高剂量的患者在住院后患有持续使用阿片类药物的风险更大.
- 在机内通风阿片剂量,先前的阿片类药物使用和出院后的阿片类药物使用之间没有发现显著的相互作用.
结论:
- 在机械通风期间服用阿片类药物与阿片类药物处方的增加以及在出院后持续使用有关.
- 需要进一步研究在机械通风过程中降低阿片类药物剂量策略的风险和益处.
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