重新评估Halm在社区获得性肺炎管理中的临床稳定性标准
Simone Bastrup Israelsen1, Markus Fally2, Pernille Brok Nielsen3,4
1Center of Research and Disruption of Infectious Diseases, Department of Infectious Diseases, Copenhagen University Hospital - Amager and Hvidovre, Hvidovre, Denmark simone.elisabeth.bastrup.israelsen.02@regionh.dk.
The European respiratory journal
|August 22, 2024
概括
哈尔姆的社区获得性肺炎 (CAP) 稳定性标准需要在今天的老年,更生病的患者中更长的时间. 早期的稳定性仍然表明并发症较少,特别是那些没有做-不-复苏命令的人.
科学领域:
- 临床医学 临床医学
- 传染性疾病 传染性疾病
- 肺部病理学 肺部病理学
背景情况:
- 1998年建立的Halm临床稳定性标准指导社区获得性肺炎 (CAP) 的治疗和出院.
- 原始标准基于有限的,选择患者队列.
- 需要重新评估当代的,现实世界的农业政策管理.
研究的目的:
- 重新评估Halm临床稳定性标准在当前的CAP患者群体中的适用性.
- 评估临床稳定性和不稳定性复发的时间.
- 分析与临床稳定性里程碑相关的严重并发症和死亡率.
主要方法:
- 在丹麦 (2017-2020年) 对2918名免疫能力较强的CAP患者进行的队列研究.
- 主要结局:根据哈姆标准,达到临床稳定的时间.
- 使用累积发病率和卡普兰-梅尔曲线进行分析,考虑竞争风险.
主要成果:
- 在患有并发症的老年人群 (平均年龄75岁) 中,临床稳定的中位时间为4天.
- 在早期反应 (3天内) 后,五分之一的患者经历了不稳定的复发.
- 在早期响应者中,30天死亡率总体为5.1%,在没有DNR命令的人中较低 (1.7%).
结论:
- 哈姆的标准仍然有效地对CAP疾病过程进行分类.
- 当代,老年患有并发症的患者需要更长时间才能达到稳定.
- 早期临床反应与降低并发症风险相关,特别是在没有做-不-复苏命令的患者中.
相关概念视频
01:28Pneumonia IV: Management
312
The treatment of pneumonia varies based on its severity and the causative pathogen. Here is a structured approach to managing pneumonia, integrating pharmaceutical and supportive care strategies.
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
312
01:30Pneumonia III: Complications and Assessment
191
Pneumonia poses the potential for numerous complications that warrant consideration. These complications include the following:
191
01:30Pneumonia V: Nursing management and Prevention
1.9K
Nursing management of pneumonia involves promoting airway patency, facilitating rest and conserving energy, encouraging fluid intake, maintaining nutrition, and educating patients.
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
1.9K
01:30Pneumonia I: Introduction
215
Pneumonia is an acute respiratory infection that targets the lungs, specifically the alveoli. These tiny air sacs, essential for oxygen exchange, become engorged with pus and fluid, severely hindering breathing, decreasing oxygen absorption, and causing significant pain and discomfort during respiration.
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
215
01:27Chronic Obstructive Pulmonary Disease-IV: Assessement and Diagnostic Studies
2.5K
Assessing and diagnosing Chronic Obstructive Pulmonary Disease (COPD) involves a detailed approach that includes a comprehensive review of medical history, physical examination, and a variety of diagnostic tests. This thorough evaluation is essential to ensure an accurate diagnosis and guide effective management strategies.
Medical History
Medical History
2.5K
01:19Respiratory Assessment: Purpose and Indications
1.0K
Respiratory assessment is a cornerstone of nursing assessments, crucial for the early detection of patient deterioration. This evaluation transcends routine procedures, representing a critical skill nurses must master to ensure optimal patient care.
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...
1.0K