机械通风患者的腹:一个嵌套的多中心子研究
Joanna C Dionne1, Jennie Johnstone1, Diane Heels-Ansdell1
1Departments of Medicine, Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
腹影响超过60%的侵入性通风ICU患者. 关键的危险因素包括先前的C. difficile感染,抗生素,药和高蛋白肠道营养.
科学领域:
- 临界护理医学 临界护理医学
- 胃肠病学 胃肠病学
- 传染性疾病 传染性疾病
背景情况:
- 腹是重症监护室 (ICU) 患者常见的并发症,需要侵入性机械通风.
- 了解其患病率,风险因素和结果对于优化患者护理至关重要.
研究的目的:
- 为了确定侵入性通风ICU患者腹的发病率和流行率.
- 为了确定与此种人群中腹相关的风险因素和临床结果.
- 分析严重病患者的腹和死亡率之间的关联.
主要方法:
- 使用布里斯托尔便图对2650名在44个重症监护室的入侵通风患者的肠道排便的前性记录.
- 收集有关风险因素 (例如,C. difficile病史,药物,营养) 和患者结果的数据.
- 考克斯比例危险回归用于分析风险因素和死亡率相关性.
主要成果:
- 腹发生在60.4%的患者中,每 ICU 研究日发生率为18.2%.
- 确定了独立的危险因素:先前的Clostridioides difficile感染,药使用,抗生素使用和肠道营养 (特别是中度高蛋白).
- 在调整严重程度和其他因素后,腹与死亡风险增加无关.
结论:
- 腹在侵袭性通风ICU患者中非常普遍.
- 风险因素是多因素的,包括感染史,药物和营养支持.
- 虽然与更长的ICU停留有关,但腹在这个队列中没有增加住院死亡率.
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