患有逆血压下降表型的重症患者患有妄想和死亡的风险增加
Nadim El Jamal1, Thomas G Brooks1, Antonijo Mrcela1
1Institute for Translational Medicine and Therapeutics (ITMAT), University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
medRxiv : the preprint server for health sciences
|February 20, 2025
概括
在ICU中睡眠-觉醒周期的中断会增加妄想风险. 反向血压下降是狂妄症的早期指标,在重症监护病房患者中增加了死亡风险.
科学领域:
- 关键护理医学 关键护理医学
- 时间生物学 时间生物学
- 生物医学数据科学是生物医学数据科学.
背景情况:
- 重症监护室 (ICU) 的环境会扰乱患者的昼夜节律,导致睡眠和清醒周期失调.
- 这种失调增加了妄想的风险,给医疗保健系统带来了巨大的财务负担.
- 了解ICU中特定时间的患者表型对于预测临床结果至关重要.
研究的目的:
- 分析来自ICU患者的高分辨率生理数据中的节律成分与 Delirium 和死亡的发生率之间的关联.
- 调查临床实验室值在危险的ICU患者群体24小时波动的差异,以确定潜在的机制和预后指标.
主要方法:
- 从24小时的血压和心率数据中提取了节奏组件,使用MIMIC IV数据库中的浸泡比率和JTK_CYCLE统计数据.
- 后勤回归模型评估了被破坏的生命信号节奏与随后的妄想或死亡之间的联系.
- 分析了前24小时的临床实验室测量结果,以模拟节律模式及其与不良结果的关联.
主要成果:
- 呈现逆血压下降的患者患狂妄症的风险增加了40% (OR: 1.40) 和死亡风险增加了13% (OR: 1.13).
- 反向浸泡者显示了24小时的生物化学概况,表明与夜间浸泡者相比,脏,代谢和静血功能中的昼夜程序发生了变化.
- 减缓或逆转心率和血压节奏与ICU患者死亡风险增加相关.
结论:
- 反向血压下降可能是ICU中痴呆症发展的早期预测因素,与广泛的昼夜干扰有关.
- 在ICU患者中,生命信号节律的扰乱与 Delirium 和死亡率的风险增加有关.
- 将这些基于节律的风险因素纳入预防性护理策略可以提高患者的治疗成果,并减轻医疗保健系统的成本.
相关概念视频
01:17Measurement of Blood Pressure
817
Assessing blood pressure is a standard procedure executed in virtually all medical environments. The method utilized today was established over a hundred years ago by an innovative Russian doctor, Dr. Nikolai Korotkoff. The soft ticking noise, known as Korotkoff sounds, heard while taking blood pressure readings results from turbulent blood flow within the vessels. The apparatus required for this procedure includes a sphygmomanometer, a blood pressure cuff attached to a gauge, and a...
817
01:24Blood Pressure Imbalances and Circulatory Shock
732
Disorders affecting blood volume, vascular tone, or vascular function can disrupt vascular homeostasis, including conditions like hypertension, hemorrhage, and shock.
Blood Pressure: Hypertension and Hypotension
Normal blood pressure is 120/80 mm Hg. Elevated blood pressure is 120-129/under 80 mm Hg. Hypertension, warranting treatment at 130/80 mm Hg, is often asymptomatic and can lead to severe cardiovascular events, aneurysms, peripheral arterial disease, chronic renal disease, or cardiac...
Blood Pressure: Hypertension and Hypotension
Normal blood pressure is 120/80 mm Hg. Elevated blood pressure is 120-129/under 80 mm Hg. Hypertension, warranting treatment at 130/80 mm Hg, is often asymptomatic and can lead to severe cardiovascular events, aneurysms, peripheral arterial disease, chronic renal disease, or cardiac...
732
01:30Alterations in Blood Pressure
1.2K
Alterations in blood pressure, such as hypertension (high blood pressure) and hypotension (low blood pressure), significantly affect human health. Understanding these conditions' classifications, causes, and symptoms is essential for effective management and treatment.
Hypertension (High blood pressure)
Hypertension occurs when blood pressure readings consistently exceed the normal range. It is diagnosed when systolic blood pressure (the top number, indicating pressure while the heart...
Hypertension (High blood pressure)
Hypertension occurs when blood pressure readings consistently exceed the normal range. It is diagnosed when systolic blood pressure (the top number, indicating pressure while the heart...
1.2K
01:23Acute Respiratory Failure-IV
118
Respiratory failure can manifest suddenly or gradually, characterized by a rapid decline in PaO2 and a rapid rise in PaCO2. This situation indicates a severe respiratory problem that may quickly become a life-threatening emergency. One of the early signs of hypoxemic Acute Respiratory Failure (ARF) is a change in mental status due to the brain's sensitivity to oxygen levels and changes in acid-base balance. Symptoms such as restlessness, confusion, and agitation suggest inadequate oxygen...
118
01:25Errors occurring during blood pressure monitoring
583
Blood pressure monitoring is a crucial clinical procedure in diagnosing and managing various cardiovascular conditions. Despite its significance, the accuracy of blood pressure measurements can be compromised by multiple factors, potentially leading to either falsely high or low readings. These inaccuracies are critical as they can significantly impact patient care. So, it is vital to understand these challenges deeply and adopt strategic approaches to minimize errors.
Several factors...
Several factors...
583
01:28Special considerations while measuring blood pressure
700
When assessing blood pressure (BP), healthcare professionals must consider various factors and potential unexpected outcomes to ensure accurate readings and provide proper patient care. Adhering to these guidelines is essential to achieving the most reliable results.
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
700