关于法国重症监护病房心脏骤停后护理和温度管理最近变化的实践调查
Clément Haddadi1, Antoine Kimmoun2, Marine Jacquier3
1CHRU Nancy, Service de Réanimation Médicale Brabois, Pôle Cardio-Médico-Chirurgical, Vandoeuvre-les-Nancy, France.
Journal of critical care
|August 31, 2024
概括
法国重症监护病房越来越多地使用针对性温度管理 (TTM),遵循最近的指南. 然而,对心脏骤停后护理的新建议的全面实施仍在等待,中度低温仍然普遍存在.
科学领域:
- 关键护理医学 关键护理医学
- 心脏病学 心脏病学
- 紧急医疗 紧急医疗
背景情况:
- 最近的指导方针将心脏骤停后 (CA) 的管理从低温转变为有针对性的治疗管理 (TTM).
- 评估法国重症监护病房 (ICU) 采用这些新的TTM建议是至关重要的.
研究的目的:
- 评估在更新的TTM指南发布后,法国ICU中CA后管理实践的变化.
- 确定与使用温度反装置的TTM相关的因素.
主要方法:
- 两项基于网络的调查于2023年3月至8月期间进行,将数据与2015年调查进行了比较.
- 联系了来自法国276个中心的389个部门,有334名医生和660名护士参与其中.
主要成果:
- 95.5%的医生报告使用TTM,其中64%使用温度反设备.
- 目标温度从32-34°C (2015) 增加到35-36°C (2023),反设备的TTM从45%增加到65%.
- 大学医院附属性,高CA入院率,书面CA程序和阴道实验室存在与TTM反设备使用有关.
结论:
- 虽然TTM的采用率很高,但最新的建议没有得到充分实施,中度低温仍然很常见.
- 用于温度反装置的TTM使用量显著增加,但系统中的异质性和缺乏反仍然令人担忧.
- 当地约束和设备成本影响TTM系统的选择,需要进一步关注以确保最佳的复苏后护理.
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