稳定的儿科手术患者的日常一夜评估:一个关键的重新考虑
Morgan Brown1, Rebecca Moreci1, Hannah Megison2
1Louisiana State University Health Sciences Center, Department of Surgery, 2021 Perdido St, New Orleans, LA, 70112, USA; Our Lady of the Lake Children's Health, Division of Pediatric Surgery, 8300 Constantin Blvd, Baton Rouge, LA, 70809, USA.
在儿科手术患者的夜间生命体征监测很少导致干预,尽管经常出现异常. 通过例行评估优先考虑患者安全至关重要,直到特定的患者群体可以被确定为减少监测.
科学领域:
- 儿科手术 儿科手术
- 关键护理医学 关键护理医学
- 睡眠医学 睡眠医学
背景情况:
- 一夜间的生命体征 (OVS) 监测会扰乱住院患者的睡眠,可能导致不良后果.
- 之前的研究表明,OVS检查很少在儿科患者群体中检测出重大事件.
- 这项研究调查了儿童手术患者OVS监测的实用性.
研究的目的:
- 为了确定儿科手术患者异常OVS的频率.
- 评估异常OVS导致的干预率.
- 评估该队列中OVS发现的临床意义.
主要方法:
- 从2019-2021年对354名儿科手术患者 (5-19岁) 的回顾性图表审查.
- 排除重症监护室 (ICU) 患者.
- 对在晚上10点至早上6点之间记录的OVS和随后的干预进行分析.
主要成果:
- 62%的患者至少表现出一种异常的OVS,最常见的是异常血压 (80%).
- 在58%的被标记的OVS中,记录了干预措施,主要是药物管理 (54%).
- 非计划性手术 (0.9%) 和重症监护室转移 (1.4%) 是不常见的,但发生了.
结论:
- 虽然大多数儿科手术患者有异常的OVS,但很少有重大干预.
- 为了患者的安全,支持进行常规的生命体征评估.
- 需要进一步的研究来确定可以从减少睡眠障碍中受益的患者子组.
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