神经肌肉阻断剂在重症监护运输中的使用与输管不相关
Alyson M Esteves1, Kalle J Fjeld1, Andre S Yonan1
1Dartmouth-Hitchcock Medical Center, Lebanon, NH.
神经肌肉阻断剂 (NMBA) 经常用于关键护理运输的呼吸机失调,不仅仅是输管. 建议进行更深的镇静和重新评估NMBA需求,以获得更好的患者护理.
科学领域:
- 关键护理医学 关键护理医学
- 紧急医疗服务 紧急医疗服务
- 药理学 药理学是指药理学的学科.
背景情况:
- 神经肌肉阻断剂 (NMBA) 已经在重症监护中发挥了重要作用.
- 它们在重症监护运输中的使用超出了输管治疗的范围,有各种迹象.
- 了解这些迹象对于优化患者管理至关重要.
研究的目的:
- 调查在重症监护运输过程中使用NMBA的指示.
- 在这种情况下,描述NMBA使用和相关的镇静策略.
- 确定改善NMBA利用和患者镇静的机会.
主要方法:
- 在重症监护运输期间接受NMBA的成年患者的回顾性队列研究 (2020年7月 - 2023年5月).
- 排除接受NMBA仅用于输管治疗的患者.
- 分析主要指示,NMBA类型,镇静得分,策略和运输后的延续.
主要成果:
- 126名患者符合纳入标准;56.4%接受了NMBA用于呼吸器异步.
- 罗库是最常见的NMBA (89.7%).
- 平均NMBA前镇静得分为-3.7;76.2%使用联合输液/玻尿酸镇静;57.1%在入院后继续使用NMBA.
结论:
- 呼吸器失调和继续前期治疗是NMBA在重症监护运输中使用的常见原因.
- 有机会优化深度镇静,并重新评估NMBA管理的必要性.
- 进一步的研究可以在医院前重症监护机构中改进NMBA协议.
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