在患有生理上困难的呼吸道的重症成年人中进行气管管道输入. 一个国际的德尔菲研究研究
Kunal Karamchandani1, Prashant Nasa2,3, Mary Jarzebowski4
1Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, TX, USA. kunal.karamchandani@utsouthwestern.edu.
Intensive care medicine
|August 20, 2024
概括
专家的共识提供了指导,以管理生理上困难的呼吸道在重症成年人. 关键建议包括团队准备,血液动力学优化和特定的输管技术,以改善患者的治疗结果.
科学领域:
- 关键护理医学 关键护理医学
- 麻醉学 麻醉学
- 航空航道管理的管理.
背景情况:
- 在重症成年人中,生理上困难的呼吸道 (PDA) 管理需要标准化的做法.
- 现有的指导方针可能无法完全解决在重症监护机构中PDA的复杂性.
研究的目的:
- 建立基于共识的临床实践陈述,用于PDA的重病成年人呼吸道管理.
- 提供专家指导,以改善气管管道输液过程中的患者安全和结果.
主要方法:
- 使用了Delphi过程,涉及35名专家临床医生研究人员的国际小组.
- 为了在实践陈述上达成稳定的共识,进行了七轮调查.
- 危急护理麻醉师协会 (SOCCA) 召集了专家小组.
主要成果:
- 在61个陈述中,共 53 个陈述达成共识 (87%的同意).
- 怀孕和肥胖被确定为导致PDA的条件.
- 建议包括三位提供者输入管组,检查清单使用,血液动力学优化,头部升高喉腔镜检查,例行视频喉腔镜检查,使用NIV进行先氧化,并仔细进行呼吸暂停阶段通风.
结论:
- 德尔菲方法成功生成了53个专家认可的PDA管理实践陈述.
- 这些陈述为危急病患者安全的气管管道输液提供了全球指导.
- 需要进一步的研究来评估这些实践陈述的影响.
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