标准自发呼吸试验参数可能无法预测创伤患者的非计划性再输管
Caroline Given1, Melissa Chang1, Natassia Dunn1
1University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA.
像RSBI和NIF这样的自发呼吸试验参数不能预测创伤患者的再输管. 高龄和较高的伤害严重性评分 (ISS) 是无计划再输管的关键预测指标.
科学领域:
- 关键护理医学 关键护理医学
- 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:
- 关于自发呼吸试验 (SBT) 参数的预测价值存在不确定性,例如负吸气力 (NIF) 和快速浅呼吸指数 (RSBI),用于创伤患者 (TPs) 的重新灌输.
- 识别可靠的预测计划外再输管 (UR) 的可靠预测因素对于优化创伤护理患者的结果至关重要.
研究的目的:
- 为了确定从机械呼吸器抽管外的创伤患者 (TPs) 计划外的再输管 (UR) 的预测因素.
- 评估TPs中SBT参数 (RSBI和NIF) 和UR之间的关联.
主要方法:
- 在2017年1月至2023年12月期间,对18岁及以上的创伤患者 (TPs) 进行了回顾性研究,这些患者从机械通风中抽出管道.
- 在住院期间经历了UR的患者与没有经历UR的患者进行了比较.
- 进行了多变量逻辑回归分析,以确定与UR相关的风险因素.
主要成果:
- 在424个TP中,39个 (9.2%) 经历了UR. 与没有UR的患者相比,UR患者年龄较大,受伤严重程度得分 (ISS) 更高.
- 伴随性疾病,如充血性心力衰竭,肝硬化和末期病在UR组中更为普遍.
- 无论是RSBI还是NIF值都没有与UR的风险增加有显著的关联;然而,晚年和更高的ISS独立地与UR相关.
结论:
- 自发呼吸试验参数 (RSBI和NIF) 不是可靠的预测器在创伤患者计划外的再输管.
- 患者年龄和受伤严重程度评分 (ISS) 是无计划再输管的重要独立预测指标.
- 在创伤患者的临床决策中,应考虑超出标准SBT参数的患者特异性因素.
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