在被直管的儿科创伤患者中,呼吸机相关肺炎的预测因素
Fnu Avinash1, Jeffry Nahmias1, Negaar Aryan1
1Department of Surgery, Division of Division of Trauma, Burns and Surgical Critical Care, University of California, Irvine Medical Center, 3800 Chapman Ave, Suite 6200, Orange, Irvine, CA, 92868-3298, USA.
Pediatric surgery international
|July 17, 2025
概括
无计划的再灌输,创伤性脑损伤 (TBI) 和严重的胸部损伤是儿童创伤患者呼吸机相关性肺炎 (VAP) 的关键风险因素. 识别这些因素可以指导干预措施,以减少VAP发生率和改善结果.
科学领域:
- 创伤外科 手术 创伤外科
- 关键护理医学 关键护理医学
- 儿科重症监护室的儿童重症监护室
背景情况:
- 呼吸机相关性肺炎 (VAP) 是儿童创伤患者 (PTP) 的一个严重并发症.
- VAP增加了死亡率和医疗保健成本,需要识别相关的风险因素.
- 早期识别风险因素可以为有针对性的干预提供信息.
研究的目的:
- 在被直管的儿科创伤患者中识别与VAP相关的风险因素.
- 分析来自创伤质量改善计划数据库 (2017-2021) 的数据.
- 为了比较带有VAP和没有VAP的PTP之间的结果.
主要方法:
- 对2017-2021创伤质量改善计划数据库的回顾性分析.
- 包括所有被直管的儿科创伤患者.
- 两变量和多变量后勤回归分析以确定风险因素.
主要成果:
- 在38593名被直管的PTP中,819名 (2.1%) 患有VAP.
- VAP队列显示了较高的损伤严重程度得分,创伤性脑损伤 (TBI),肋骨骨折和肺部损伤.
- VAP的独立风险因素包括无计划的再灌输 (OR 2.51),TBI (OR 1.96) 和严重的胸部损伤 (OR 1.27).
结论:
- 无计划的再输管,TBI和严重的胸部损伤是输管PTP中VAP的重要风险因素.
- 这些发现强调了需要制定策略来尽量减少再输管的必要性.
- 优化高风险PTP的呼吸机管理和肺部护理至关重要.
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