胺可以防止因激动而不能遵守NIV的患者输管吗?
Çağatay Nuhoğlu1,2, Görkem Alper Solakoğlu3, Ferhat Arslan4
1Emergency Department of Şişli Hamidiye Etfal Training and Research Hospital Huzur Mh, Cumhuriyet, Sarıyer, İstanbul, 34396, Turkey. nuhoglucagatay@gmail.com.
BMC emergency medicine
|October 11, 2024
概括
胺可以帮助急性呼吸衰竭的激动患者遵守非侵入性机械通风 (NIMV). 然而,动荡仍然会影响NIMV的成功,可能需要侵入性机械通风 (IMV).
科学领域:
- 紧急医疗 紧急医疗
- 关键的护理关键的护理
- 药理学 药理学是指药理学的学科.
背景情况:
- 当氧气支持不足时,急性呼吸衰竭需要非侵入性机械通风 (NIMV).
- 接受NIMV治疗的患者的激动往往导致不良遵守,需要侵入性机械通风 (IMV).
- 镇静剂可能会减轻激动患者对IMV的需求.
研究的目的:
- 为了研究胺剂的管理对NIMV遵守激动的急性呼吸衰竭患者的影响.
- 为了评估胺使用,NIMV遵守和这个患者群体内输管率之间的关系.
主要方法:
- 对81名急性呼吸衰竭患者的回顾性研究,这些患者于2021年至2022年期间入院ED.
- 利用里士满兴奋镇静量表 (RASS) 来量化患者的兴奋程度.
- 评估了胺剂和NIMV遵守率与输管率之间的关联.
主要成果:
- 46.8%的患者尽管服用了胺,但仍需要输管;43.2%符合NIMV并避免输管.
- 与符合NIMV (2.17 ± 0.68) (p=0.003) 的患者相比,被直管的患者显示出显著更高的RASS得分 (2.66 ± 0.73),与符合NIMV (2.17 ± 0.68) 的患者相比 (p=0.003).
- 在很大一部分患者中,胺的使用并没有完全克服激动性诱导的NIMV不遵守.
结论:
- 在急性呼吸衰竭患者中,兴奋是符合NIMV的重要障碍.
- 虽然胺可以提供一些好处,但大量激动患者仍然需要侵入性机械通风.
- 对最佳镇静策略的进一步研究是有必要的,以提高激动患者的NIMV成功率.
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