使用输出管辅导员决策支持 (LEADS) 从机械通风中解放:多中心试验试验的协议
Karen E A Burns1,2, Jill E Allan3, Emma Lee4
1Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, North America, Canada Karen.Burns@unityhealth.to.
BMJ open
|March 19, 2025
概括
这项试点试验评估了输出管辅导员 (EA) 决策支持工具的可行性,以改善重症患者的输出管准备. 这些发现将为未来优化机械通风释放的试验提供信息.
科学领域:
- 关键护理医学 关键护理医学
- 呼吸系统疗法 呼吸系统疗法
- 临床决策支持 临床决策支持
背景情况:
- 成功的输出管对于尽量减少患者暴露在侵入性通风中,降低成本和改善结果至关重要.
- 目前的策略缺乏强有力的评估,以告知输出的决策.
- 在LEADS试点试验中,引入了一种新的输出管辅导员 (EA) 工具来弥补这一差距.
研究的目的:
- 评估进行一项较大的试验的可行性,用于一种新的输出的决策支持工具.
- 评估关键可行性指标,包括招聘,同意,随机化和遵守率.
- 探索医生对EA工具的实用性和实施成本的看法.
主要方法:
- 一项试点随机对照试验,涉及重病成年人入侵通风≥48小时.
- 干预臂:患者接受输出管辅导员 (EA) 评估,测量输出管准备状态的呼吸速率变化.
- 控制组:患者接受标准护理;不使用EA报告.
主要成果:
- 该研究旨在在10个中心招募1-2名患者/月.
- 目标可行性结果包括>75%的同意率,>95%的随机化,>80%的干预坚持,<10%的交叉和>90%的完整临床结果.
- 将报告医生对EA工具有用性的看法.
结论:
- 这项试点研究对于确定对输出管导师进行最终试验的可行性至关重要.
- 成功实施LEADS试验将为优化输出管的策略提供关键数据.
- 这些发现将指导未来的研究,通过在机械通风释放过程中加强决策支持来改善患者的治疗结果.
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