关于从机械通风机中脱胎的ISCCM委员会立场声明
Anuj M Clerk1, Ritesh J Shah2, Jay Kothari3
1Department of Intensive Care, Sunshine Global Hospital, Surat, Gujarat, India.
概括
这份共识声明提供了最新的指导方针,用于在重症监护病房中将患者从机械呼吸机中断奶. 它提供了39个基于证据和专家意见的建议,以改善患者的治疗结果,并降低再化率.
科学领域:
- 临界护理医学 临界护理医学
- 肺部病理学 肺部病理学
- 重症监护病房管理部门的管理.
背景情况:
- 机械通风 (MV) 断奶对于重症患者的康复至关重要.
- 未能断奶和随后的再化会对患者的治疗结果产生负面影响.
- 在重症监护病房 (ICU) 中,MV和断奶的做法有很大差异.
研究的目的:
- 为现代ICU中机械呼吸机断奶提供最新的,基于文献的指南.
- 建立第一个ISCCM (印度重症护理医学学会) 关于断奶的共识声明.
- 为了指导重症治疗师,注册医生,护士和呼吸治疗师在断奶协议.
主要方法:
- 由ISCCM设立的MV断奶委员会进行了全面的文献审查.
- 该声明是通过专家委员会成员和ISCCM指南委员会多轮同行评审来制定的.
- 建议使用修改后的GRADE系统进行分类,考虑成本效益,风险效益和印度ICU的可行性.
主要成果:
- 该文件涉及42个关于断奶的问题,结果有39个建议 (32个基于证据,7个专家意见).
- 涵盖的关键领域包括断奶标准,方法,失败诊断,使用非侵入性通风 (NIV) 和高频振荡通风 (HFOV),气管切除术,以及物理治疗,营养和隔膜超声波的作用.
- 该声明包括27个强有力的建议和12个弱小的建议 (建议).
结论:
- 本指南提供了对机械通风机断奶的广泛审查和众多建议.
- 它旨在标准化和改进重症监护机构的断奶实践.
- 建议定期审查,以纳入呼吸机断奶中的新兴概念和标准.
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