在通风重症监护病人的断奶失败的预测因素:一个系统的证据地图
Fritz Sterr1,2, Michael Reintke3,4, Lydia Bauernfeind3,5
1Faculty of Health, School of Nursing Sciences, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, 58455, Witten, Germany. fritz.sterr@uni-wh.de.
Critical care (London, England)
|November 13, 2024
概括
鉴定呼吸机断奶失败的预测因素对于重症监护患者至关重要. 这项研究在140项研究中绘制了145个预测因素,突出了生理参数和指数作为研究的关键领域.
科学领域:
- 关键护理医学 关键护理医学
- 肺部病理学 肺部病理学
- 呼吸系统疗法 呼吸系统疗法
背景情况:
- 长时间的机械通风对重症监护室 (ICU) 患者构成风险.
- 从呼吸机中立即断奶并不总是成功的,导致输出管失败和重新输入管.
- 识别患有断奶失败高风险的患者对于预防并发症至关重要.
研究的目的:
- 系统地审查和概述所有经验研究的断奶失败预测因素.
- 巩固现有关于影响成功输出管的因素的知识.
主要方法:
- 使用来自Medline,Cochrane和CINAHL数据库的数据开发了一个系统的证据地图.
- 搜索是在2023年12月进行的,在2024年6月进行了额外的引用和手动搜索.
- 包括专注于成人ICU患者的研究;不包括对儿童,非侵入性通风或解释因素的研究.
主要成果:
- 包括140项分析145个独立预测断奶失败的预测因素的研究.
- 预测器被分为"成像程序" (22),"生理参数" (61),"分数和指数" (53) 和"机器学习模型" (9).
- 最常被研究的预测因素包括快速浅呼吸指数,隔膜加厚分数,呼吸速率,P/F比率和隔膜外游.
结论:
- 风扇断奶失败预测因素已经得到了广泛的研究,在140项研究中确定了145项.
- 最近的研究强调了综合评估,指数和机器学习模型,而不是个人预测因素.
- 未来的研究应该与国际断奶定义保持一致,并探索研究不足的预测因素.
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