在COVID-19大流行之前,连续两年从重症监护室收集的气管切除术相关数据
Maria Papaioannou1, Evdoxia Vagiana2, Serafeim-Chrysovalantis Kotoulas3
11 Intensive Care Unit, G Papanikolaou General Hospital, Exohi, Thessaloniki 57010, Greece.
World journal of methodology
|July 10, 2024
概括
在ICU患者的早期气管切除术显著减少机械通风和ICU停留时间. 穿皮扩张气管切除术 (PDT) 和手术气管切除术 (ST) 在结局或并发症方面没有显著差异.
科学领域:
- 关键护理医学 关键护理医学
- 手术手术手术手术手术手术手术手术手术手术
- 呼吸系统疗法 呼吸系统疗法
背景情况:
- 气管切除术是需要长时间机械通风或上呼吸道阻塞的ICU患者的常见手术.
- 关于气管切除术的最佳时间,技术和益处,存在相互矛盾的证据.
- 了解第三级护理ICU的实践模式和结果对于基于证据的决策至关重要.
研究的目的:
- 分析气管切除术在第三级护理重症监护室中的特征,时间和结果.
- 为了比较早期与晚期的气管切除术和皮肤透气管切除术 (PDT) 与外科手术气管切除术 (ST).
- 评估气管切除术时间和技术对机械通风持续时间,ICU停留时间和存活率的影响.
主要方法:
- 两年来对成年重症监护患者进行的回顾性队列研究.
- 收集的数据包括人口统计,疾病严重程度 (APACHE II),意识 (GCS),并发症,气管切除术时间和类型.
- 早期的气管切除术被定义为8天内放置;晚期是8天后或没有气管切除术.
主要成果:
- 在660名患者中,115人接受了气管切除术 (63人早期,52人晚期).
- 早期的气管切除术与机械通风时间显著缩短 (15.3 vs. 22.8天) 和ICU停留时间 (18.8 vs. 25.4天) 相关.
- 在有中枢神经系统问题的老年患者中,PDT是首选的;ST被选择用于受损的呼吸道. 早期/晚期组之间的VAP或生存没有显著差异.
结论:
- 与ST相比,PDT经常使用,但没有影响通风日,VAP,ICU停留时间或存活率.
- 早期气管切除术显著减少了机械通风的持续时间和ICU停留时间.
- 对于PDT或ST都没有报告任何并发症,这表明这两种在这个队列中都是安全的.
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