在严重酸盐中毒的成年人中进行气管管道输入和机械通风
Brooke A McDonald1, Megan Conlon1, Alexandru Ulici2
1Division of Pulmonary, Allergy, and Critical Care, Department of Medicine, Hennepin County Medical Center, Minneapolis, Minnesota.
The Journal of emergency medicine
|July 19, 2024
概括
在严重的酸盐中毒中,气管输管没有显著改变血清pH值或引起并发症. 这挑战了在这些关键酸干扰患者中避免机械通风的常见做法.
科学领域:
- 毒理学 毒理学 毒理学
- 关键护理医学 关键护理医学
- 紧急医疗 紧急医疗
背景情况:
- 酸盐中毒会导致严重的酸干扰.
- 气管管道输入和机械通风通常在严重的沙利西里斯症中不被鼓励.
研究的目的:
- 为了研究酸盐中毒患者的pH趋势和并发症,这些患者接受了气管管道输液.
- 评估机械通风在严重的酸盐中毒中的安全性和结果.
主要方法:
- 对患有严重酸盐中毒的成年人进行回顾性观察研究 (血清酸盐>40 mg/dL,ICU入院).
- 在14年 (2007-2021) 中从急诊室演示中收集的数据.
- 主要结局:血清pH值发生变化;次要结局:输管后6小时内发生严重并发症.
主要成果:
- 在32名 (34%) 患有严重酸盐中毒的患者中,有11名被直管.
- 输管前后血清pH值的平均绝对差异是最小的 (-0.02).
- 在输管过程中或输管后6小时内没有发生严重并发症 (低血压,缺氧,心脏骤停).
结论:
- 在严重的酸盐中毒中,气管输管和机械通风与显著的pH值变化或不良事件无关.
- 研究结果表明,目前阻碍这些干预措施的指导方针可能需要重新评估.
- 这种单一中心的经验挑战了管理严重沙主义的既定范式.
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