在患有严重支气管炎的婴儿中,护士驱动的非侵入性呼吸辅助停药协议的影响
Julie Cassibba1, Marie Chevallier2, Aurélie Alexandre3
1Pediatric Department, Grenoble Alpes University Hospital, Grenoble, France.
概括
一个护士驱动的协议,用于呼吸支停止的婴儿与支气管炎没有增加断奶失败. 然而,它导致了后来的支持撤回,但断奶时间更短.
科学领域:
- 儿科重症监护室的儿童重症监护室
- 呼吸系统医学 呼吸系统医学
- 护理实践 护理实践
背景情况:
- 支气管炎是儿童重症监护室 (PICU) 入院的常见原因.
- 对于患有严重支气管炎的婴儿,经常需要非侵入性呼吸支持.
- 优化呼吸器支停止治疗对于患者的治疗结果和资源利用至关重要.
研究的目的:
- 评估护士驱动的呼吸器支停药方案对患有支气管炎的婴儿的影响.
- 为了比较护士驱动的协议和标准的医生驱动的管理之间的结果.
主要方法:
- 追溯性,单中心研究,前后比较设计.
- 包括187名婴儿被录入第三级PICU,患有支气管炎.
- 分析断奶失败,支停止时间,断奶时间,通风总持续时间和停留时间.
主要成果:
- 在护士驱动 (15%) 和标准 (12%) 协议组之间,断奶失败率没有显著差异 (p=0.46).
- 呼吸器支停止发生在护士驱动的协议 (44小时对33小时,p=0.001) 之后.
- 哺乳期的持续时间较短的护士驱动的协议 (24小时对39小时,p=0.01).
- 整体通风持续时间和PICU/住院时间没有显著差异.
结论:
- 在患有支气管炎的婴儿中,护士驱动的呼吸辅助中止协议是安全的,没有增加断奶失败.
- 这种协议与延迟的呼吸器支退出有关,但更有效的断奶过程.
- 在这种患者群体中,护士驱动的管理可以成为停止呼吸辅助治疗的有效策略.
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