在成功的自发呼吸试验后,提供者始终推迟输出管:回顾性队列研究
Anna K Barker1, Rachel K Hechtman2,3, Megan Acho4
1University of Michigan, Ann Arbor, Michigan, United States; baanna@med.umich.edu.
Annals of the American Thoracic Society
|May 20, 2025
概括
许多患者在自发呼吸试验 (SBT) 后没有被抽管,增加了风险. 超过一半的延迟排卵缺乏明确的障碍,这表明需要进行干预,以改善机械通风的及时断奶.
科学领域:
- 关键护理医学 关键护理医学
- 肺部病理学 肺部病理学
- 呼吸系统疗法 呼吸系统疗法
背景情况:
- 许多通过自发呼吸试验 (SBT) 的患者没有被抽管,冒着风险与呼吸器相关的并发症.
- 识别及时排泄的障碍对于减少机械通风持续时间至关重要.
研究的目的:
- 在通过SBT后6小时内识别与患者相关的和患者独立的输出的障碍.
- 分析影响重症监护室及时输出管的决定的因素.
主要方法:
- 对机械通风 (2015-2023) 成年患者电子健康记录的分析.
- 混合效应多变量后勤回归来评估及时输出和潜在延迟原因之间的关联.
- 在主治医生层面对集群的计算.
主要成果:
- 在3240名患者中,62.3%的患者在经过SBT后6小时内被抽管.
- 延迟排气增加了机械通风的中位数为2.0天,占通风总时间的32%.
- 与延迟输出管相关的因素包括手术,低意识,血管压缩剂使用和大量分泌物;然而,55%的人缺乏这些障碍. 最常被引用的原因是 (43%) 喜欢参加.
结论:
- 三分之一的患者在SBT后仍然保持机械通风,超过一半的患者缺乏已知的障碍.
- 需要进一步的研究和全单位的干预措施,以增加符合条件的患者的及时输出试验.
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