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关键性创伤患者的捆绑程序:应该做吗?

Hannah Shin¹, Amy Young¹, Madison E Morgan²

¹Department of Surgery, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA.

The American surgeon

|January 31, 2025

概括

在直管创伤患者中,立即捆绑线 (IBL) 并没有改善死亡率. 然而,IBL与特定的损伤机制和患者特征有关,这表明量身定制的方法可能是有益的.

科学领域:

创伤外科手术创伤外科
关键护理医学关键护理医学
紧急医疗紧急医疗

背景情况:

随着COVID-19的流行,在被直管的患者中增加了捆绑线的做法.
立即捆绑线路 (IBL) 涉及在输管后4小时内放置中央静脉导管 (CVC) 和动脉线路 (AL).
这项研究调查了IBL对创伤患者的影响.

研究的目的:

检查直接捆绑线 (IBL) 对创伤伤害的影响.
为了确定严重受伤的患者是否受益于IBL.
在被直管的创伤患者中确定IBL的预测因子.

主要方法:

对被直管的创伤患者的回顾性审查 (2015年1月 - 2020年12月).
排除标准:18岁以下的患者,在ICU入院前死亡或转移的患者.
IBL定义为CVC和AL安置于输管后4小时内;延迟线路>4小时.

主要成果:

分析了728名患者;17.7%的患者接受了延迟线路.
严重的头部伤害,枪伤 (GSW) 和输血与IBL有关.
IBL与较低的格拉斯哥昏迷量表 (GCS) 和较高的受伤严重程度评分 (ISS) 相相关.

结论:

某些创伤机制 (GSW,行人受伤),输血和严重的ISS预测IBL.
IBL没有表现出优于直接AL的优势,也没有表现出死亡率的线条.
线对ICU或住院时间 (LOS) 没有显著的影响,除了严重的头部伤害.

关键词:

捆绑线路捆绑线路捆绑线路捆绑程序是捆绑的程序.输入管道捆绑套件输入管道捆绑拖车上的伤害.创伤重症监护室创伤重症监护室

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