基于ESICM共识的建议,用于重症监护中非常老的患者的管理
Michael Beil1, Laura Alberto2, Richard S Bourne3,4,5
1Department of Medicine, NHS Highland (ESICM HSRO Section), Inverness, UK. beil@doctors.org.uk.
Intensive care medicine
|February 17, 2025
概括
这项研究制定了专家共识的建议,对非常老 (≥80岁) 患者的重症监护. 这些指导方针涉及复杂的老年综合征,旨在减少临床不确定性和重症老年人的护理差异.
科学领域:
- 老年医学 老年医学
- 密集护理医学 密集护理医学
- 基于证据的实践.
背景情况:
- 非常老的患者 (≥80岁) 由于异质性和复杂的老年综合征而存在独特的挑战.
- 传统的基于证据的医学方法很难为这个人群指导临床实践.
- 缺乏强有力的指导导致从业人员的不确定性和关键病情的老年患者的护理变化.
研究的目的:
- 制定基于共识的建议,用于临床管理的非常老的病人,危急的条件.
- 将专家的经验知识转化为重症监护的实际指导.
- 为满足欧洲重症监护医学协会 (ESICM) 对改善老年人护理标准的需求.
主要方法:
- 一项涉及重症监护,急诊和老年医学专家的多国德尔菲研究.
- 两轮采集专家意见,使用9点的利克特等级.
- 共识定义为≥90% (强烈) 或≥80% (中度) 专家之间的同意/不同意.
主要成果:
- 根据专家的共识,制定了48份声明和2份检查清单的建议.
- 该指南涵盖了基本原则,护理目标以及关于重症监护入院,治疗和出院后管理的决定.
- 通过严格的多轮专家审议,达成共识.
结论:
- 一个多学科专家小组就非常老患者的重症监护建议达成共识.
- 这些建议得到了欧洲重症监护医学学会 (ESICM) 的批准和认可.
- 实施需要仔细的资源分析和逐步的方法.
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