儿童急性呼吸道感染的护理利用 需要侵袭性长期机械通风的儿童
Carolyn C Foster1,2, Todd A Florin2,3, Derek J Williams4
1Division of Advanced General Pediatrics, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Pediatric pulmonology
|March 5, 2025
概括
由于急性呼吸道感染 (ARI) 住院的长期机械通风 (LTMV) 的儿童通常需要密集护理. 神经功能障碍加剧了结果,强调了为这些脆弱的儿科患者制定量身定制的护理策略的必要性.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 呼吸系统药物 呼吸系统药物
- 神经学 神经学
背景情况:
- 需要入侵性长期机械通风 (LTMV) 的儿童是一个多样化的群体,经常住院治疗,主要是急性呼吸道感染 (ARI).
- 了解这一群体中与ARI相关的医疗保健利用率和死亡率模式,对于优化医疗保健至关重要.
研究的目的:
- 描述ARI相关的急诊室 (ED) 和LTMV的儿科患者的医院利用情况.
- 评估LTMV儿童中先前存在的高强度神经损伤 (HINI) 和ARI相关结果之间的关联.
主要方法:
- 对患有LTMV和ARI的儿科患者 (<21岁) 进行了一项回顾性的纵向队列研究,该研究在40家美国儿童医院进行.
- 分析了2016年10月1日至2023年6月30日的数据,检查了死亡率和ED/住院结果.
- 根据HINI的存在,患者使用经过验证的编码算法进行了分层.
主要成果:
- 该研究包括4866名患有LTMV和ARI的患者;95.1%被住院治疗,71.7%需要重症监护.
- 总体而言,死亡率为4.1%,HINI (5.3%) 的患者明显高于没有HINI (1.3%) 的患者.
- 60.7%的患者在一年内有ED复诊,最常见的是ARI.
结论:
- 患有LTMV与ARI的儿科患者经常被住院治疗,通常在重症监护机构.
- 对于HINI患者来说,结果明显更差,这表明需要针对性的干预措施.
- 基于疾病严重程度和并发症的改善资源配置对于提高这一群体的ARI结果至关重要.
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