老年机械通风ICU患者的治疗强度和结果
Maria Doroti Sousa da Rosa1, Gabriela Rech1, Regis Goulart Rosa1
1The authors are affiliated with Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil.
Respiratory care
|September 30, 2024
概括
对于需要机械通风在ICU的老年患者来说,更高的治疗强度不会改善存活率. 个性化护理计划对于重症监护病房的老年人来说至关重要.
科学领域:
- 老年医学 老年医学
- 临界护理医学 临界护理医学
- 重症监护病房 (ICU) 管理管理
背景情况:
- 全球人口正在老龄化,导致ICU中老年患者比例增加.
- 评估重症监护室 (ICU) 对非常老年患者的护理价值是一个挑战.
- 对老年ICU患者来说,平衡资源利用与最佳护理强度是复杂的.
研究的目的:
- 评估需要机械通风的老年ICU患者的生存率.
- 分析老年机械通风患者在不同治疗强度水平的生存率.
主要方法:
- 来自单一三级医疗中心的纵向ICU数据库的回顾性分析 (2008年1月至2014年12月).
- 纳入标准:年龄在80岁或以上,需要机械通风的ICU患者.
- 统计分析包括对年龄和严重程度得分的调整 (APACHE II,SOFA).
主要成果:
- 总共分析了482名需要机械通风的老年患者 (平均年龄85.84岁).
- 整体ICU死亡率为46%,医院死亡率为58%.
- 死亡率与90岁以上的年龄和较高的急性生理学和慢性健康评估 (APACHE) II分数有关,但与治疗强度 (治疗干预评分系统) 无关.
结论:
- 在需要机械通风的老年患者中,增加治疗强度与改善的生存率没有相关性.
- 这些发现表明,更高强度的护理可能不会使非常老的ICU患者受益.
- 强调需要为ICU中的老年患者制定个性化治疗策略.
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