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身体外膜氧化和日间疼痛静止:在通风患者中进行的一项比较后期研究

Christopher Remmington¹, Luigi Camporota¹, Cathrine A McKenzie²

¹Departments of Pharmacy and Adult Critical Care, Guy's and St Thomas' NHS Foundation Trust, London, Westminster Bridge Road, London, SE1 7EH, UK; Institute of Pharmaceutical Sciences, School of Cancer & Pharmaceutical Sciences, Centre for Human & Applied Physiological Sciences (CHAPS), School of Basic & Medical Biosciences, Faculty of Life Sciences & Medicine and Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, Strand, London WC2R 2LS, UK.

Intensive & critical care nursing

|May 1, 2025

概括

在非外体膜氧化 (ECMO) 患者中,观察到疼痛坐的日间变化,夜间剂量较高. 在ECMO患者中,没有出现白天变化,这可能是由于深度镇静和神经肌肉阻塞.

科学领域:

关键护理医学关键护理医学
药理学药理学是指药理学的学科.
重症监护病房管理部门的管理.

背景情况:

在 analgosedation 的日间变化可能会对患者的结果产生负面影响.
有限的数据存在于患者在体外膜氧化 (ECMO) 的 analgosedation 的日间变化.

研究的目的:

为了比较机械通风的成年患者与没有ECMO支持之间的疼痛静止剂量的日间变化.
在24小时内调查静脉输入阿片类药物和镇静剂的不同.

主要方法:

从2021年7月到2023年7月,在五个ICU进行了回顾性队列研究.
包括1277名成年患者在机械通风期间接受连续IV芬太尼和/或米达佐拉姆/普罗波,有或没有ECMO.
在48小时内收集了疼痛静止剂量数据,比较白天 (07:00-18:59) 和夜间 (19:00-06:59) 间隔.

主要成果:

在ECMO患者 (n=166) 中,没有发现疼痛静坐剂量的日间变化.
非ECMO患者 (n=1111) 与白天相比,夜间服用芬太尼和普罗波福的剂量显著增加.
在ECMO患者中,接受神经肌肉阻断药物的可能性更高 (72.3%对12.4%).

结论:

在非ECMO患者中,夜间疼痛静止剂量较高,但在ECMO患者中没有.
深度镇静和神经肌肉阻塞可能解释了ECMO患者没有白天变化.
患者和危急疾病因素有助于ECMO和非ECMO种群之间的analgosedation日间变异的差异.

关键词:

一天中节律的节奏.身体外膜氧化器的氧化重症监护室的重症监护室是重症监护室的重症监护室.机械通风机械通风机械通风机在阿片类药物中,阿片类药物镇静镇静镇静镇静

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