成人创伤患者的呼吸道管理与外科重症监护相关的结果
Elizabeth Cunningham1, Danielle O'Rourke2, Karen Fitzgerald3
1Surgical Intensive Care, Good Samaritan University Hospital, West Islip, USA.
Cureus
|December 18, 2024
概括
在创伤患者中,先进的呼吸道管理表明,早期气管切除与内内管或晚期气管切除相比,与更高的再入院率有关. 临床和社会因素也会影响结果.
科学领域:
- 临界护理医学 临界护理医学
- 创伤外科 手术 创伤外科
- 呼吸系统疗法 呼吸系统疗法
背景情况:
- 先进的呼吸道管理对于创伤患者在复苏和重症期间至关重要.
- 内内管和气管切除术是常见的方法,但它们的比较结果和最佳时间仍在争论中.
- 这项研究调查了重创患者不同呼吸道管理策略的并发症和结果.
研究的目的:
- 在重创患者中比较气管切除术与非侵入性技术和内内管管道输入.
- 检查与这些气道管理方法相关的并发症和结果.
- 探索健康的临床和社会决定因素在患者结果中的作用.
主要方法:
- 在1级创伤中心SICU (2019-2021) 中对911名成年创伤患者进行了回顾性定量研究.
- 分析包括使用ANOVA和千平方测试的呼吸器日,停留时间,肺炎,再入院和死亡率.
- 研究了临床/社会决定因素与晚期呼吸道管理≥四天的患者的结果之间的关联.
主要成果:
- 气道管理组之间肺炎或死亡率没有显著差异.
- 观察到的呼吸器日数,停留时间和再接收率 (p <0.001到p=0.028) 的显著差异.
- 早期气管切除术 (<10天) 显示了较高的再接收率 (33.3%) 与内管道输管 (2.3%) 和晚期气管切除术 (>10天) (0.0%) 相比.
- 社会决定因素 (吸烟,功能依赖) 和临床变量 (受伤严重程度,SBP,并发症) 与再入院和并发症相关.
结论:
- 经过早期气管切除术的成年创伤患者可能会增加再入院率,可能是由于受伤的复杂性.
- 健康的临床和社会决定因素与呼吸道管理并发症有关.
- 建议对更大的队列进行进一步研究,以验证这些发现和关联.
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