在外科病房持续监测生命体征:COSMOS试点项目
Nikola Anusic1, Alper Gulluoglu1, Elyad Ekrami1
1Research Fellow, OutcomesResearch Consortium, Department of Anesthesiology, Cleveland Clinic, Cleveland, OH, USA.
对术后患者的持续监测与生命体征警报产生了有用的警报和干预,不显著地减少了25%的生命体征异常. 需要进一步的研究来优化警报设置和临床反应. 关键词:生命体征,术后患者,持续监测,警报疲劳,临床干预.
科学领域:
- 关键护理医学 关键护理医学
- 医疗器械技术 医疗器械技术
- 患者监测 患者监测
背景情况:
- 对生命体征的监测对于在手术后检测患者的不稳定性至关重要.
- 当前的报警系统面临着报警疲劳和低于最佳设置的挑战.
- 持续监测警报在引发及时临床反应方面的有效性尚未得到充分证实.
研究的目的:
- 为了确定最佳的生命体征警报值和术后患者的延迟.
- 测试假设,持续监控警报减少生命体标志异常的持续时间.
- 评估警报的临床实用性和对干预措施的影响.
主要方法:
- 一项两阶段的试点研究,涉及250名接受重大非心脏手术的成年患者.
- 阶段1:在100名患者中持续监测和度,心率和呼吸率,以建模报警计数.
- 第2阶段:对150名患者进行随机对照试验,将盲目与非盲目连续监测与口头警告进行比较.
主要成果:
- 警报设置被确定为每天每名患者大约产生2-3个警报.
- 无盲监测导致生命体异常持续时间减少25% (相对效果比为0.75).
- 在未蒙蔽组中,82%的警报被认为是有用的,导致临床干预增加了60%.
结论:
- 通过选择值的持续监测,可以为术后患者产生有用的警报.
- 口头警报促使临床干预,主要是增加氧气输送.
- 虽然在统计学上并不显著,但这一趋势表明,持续监测警报在改善患者结果方面具有潜在的好处.
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