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身体的克制和相关的激动.
Shimon Cohen1,2, Avraham Meyer1,2, Nisim Ifrach1,2
1Department of Anesthesiology, Intensive Care and Pain Medicine, Meir Medical Center, Kfar Saba, Israel.
Nursing in critical care
|July 15, 2024
概括
在重症监护室 (ICU) 的身体克制是常见的,并与增加的死亡率和更长的通风持续时间有关. 制定减少身体限制使用的策略对于改善患者的治疗结果和护理至关重要.
科学领域:
- 关键护理医学 关键护理医学
- 患者安全 患者安全
- 临床结果研究研究
背景情况:
- 在重症监护室 (ICU) 的身体克制影响了大约50%的患者.
- 由于缺乏具体的协议,护理人员往往会为护理人员做出限制决定.
- 身体克制与患者受伤,激动程度增加以及创伤后应激障碍 (PTSD) 的风险增加有关.
研究的目的:
- 确定在一般ICU中使用身体束的流行率.
- 分析与身体限制相关的患者结果,包括患病率和死亡率.
主要方法:
- 在一般ICU中的647名患者的回顾性研究 (2020年1月至12月).
- 收集的数据包括人口统计数据,病史,住院时间,机械通风,28天死亡率,动 (里士满动和镇静量表 - RASS) 和药物使用.
- 分析对约束和不约束患者之间的结果进行了比较.
主要成果:
- 40%的患者需要身体克制.
- 抑制患者经历了更长的机械呼吸 (5.9 vs 0.36天) 和更高的28天死亡率 (26% vs 7%).
- 克制与增加激动,更严重的疾病严重性和更高的抗精神病药物需求有关.
结论:
- 在ICU的身体克制与增加的发病率,死亡率,激动和需要抗精神病药物有关.
- 在这项研究中发现的患者特征可以为减少身体克制率的策略提供信息.
- 制定有针对性的治疗计划至关重要,以尽量减少ICU中的身体限制.
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