在重症监护病房估计和实际体重之间的差异 - - 一个服务评估
Jonas Monsees1, Fionnuala Staunton2, Aidan Morris3
1CNM II Post Anaesthetic Critical Care Unit, Tallaght University Hospital, Dublin, Ireland.
Nursing in critical care
|February 20, 2025
概括
准确的实际体重 (ABW) 对ICU患者至关重要. 估计的体重显示出重大错误;患者比工作人员更准确,但测量体重是最佳实践.
科学领域:
- 关键护理医学 关键护理医学
- 临床营养学 临床营养学
- 药理学 药理学是指药理学的学科.
背景情况:
- 实际体重 (ABW) 对于在重症监护室 (ICU) 中准确的药物剂量和营养计算至关重要.
- 当直接测量不可能时,估计患者的体重是常见的,但这些估计的准确性往往是可疑的.
- 估计体重与实际体重之间的差异可能导致治疗干预不足最佳水平.
研究的目的:
- 为了确定实际体重 (ABW) 和估计体重 (EBW) 在ICU患者队列中的差异.
- 为了比较患者自我估计的准确性与工作人员对体重的估计.
- 评估ABW与理想体重 (IBW) 或预测体重 (PBW) 之间的差异.
主要方法:
- 一项服务评估,将100名ICU患者最初估计的体重 (由工作人员和/或患者) 与其随后测量的实际体重进行比较.
- 与ABW相比,对估计权重的误差幅度进行统计分析.
- ABW与理想体重 (IBW) 和预测体重 (PBW) 的比较.
主要成果:
- 在估计的重量中观察到很大的误差:在36%的案例中,误差>10%,在11%的案例中,误差>20%.
- 患者在估计自己的体重时更准确,平均误差为4.14% (IQR1.39-7.74).
- 在ABW和IBW (中位数18.57%) 和ABW和PBW (中位数18.15%) 之间发现了实质性的差异.
结论:
- 在ICU患者中,估计的体重具有很高的重大错误风险,应谨慎使用,特别是当直接测量是禁忌时.
- 患者对体重的自我估计比工作人员的估计更可靠,但仍然比直接测量更不准确.
- 精确测量ICU患者实际体重对于优化药物剂量和营养支持至关重要,代表最佳实践.
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