早期动员期间和之后的不良事件:对TEAM试验的特此后分析
Tessa Broadley1, Ary Serpa Neto2, Michael Bailey1
1Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
概括
在机械呼吸的成年人中,早期动员增加了不良事件,主要是心血管和呼吸系统. 这些事件在早期动员时更早发生,但没有影响患者的存活率.
科学领域:
- 关键护理医学 关键护理医学
- 临床试验分析
- 患者安全 患者安全
背景情况:
- 机械通风成年人治疗早期活动和动员 (TEAM) 试验发现,早期动员会导致更多不良事件.
- 这些不良事件的具体时间和性质需要进一步调查.
研究的目的:
- 在TEAM试验中全面分析不良事件的时间和特征.
- 了解早期动员对机械通风成年人患者安全的影响.
主要方法:
- 实时每日收集不良事件数据.
- 使用费舍尔精确测试对分类数据进行比较.
- 通过考克斯回归脆弱模型分析不良事件与患者存活率之间的关系.
主要成果:
- 早期动员组中有10.0%的不良事件发生,而常规护理组中有4.3%.
- 最常见的事件包括血压变化,心律失常和氧气不和.
- 患有不良事件的患者心血管并发症的发生率更高;事件与动员发生更早 (中位数为4天而不是7天).
结论:
- 在机械通风的成年人中,早期积极动员与心血管和呼吸系统不良事件的发生率更高有关.
- 这些事件往往发生在动员组的早期.
- 心血管并发症在经历不良事件的患者中更为普遍,为未来的研究方向提供了信息.
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