我们还有多长时间? : 对烧伤病房息式输出管的回顾性审查
Hannah M Jones1, Colette Galet1, Alexander Kurjatko1
1Department of Surgery, Division of Acute Care Surgery, University of Iowa, Iowa City, Iowa, USA.
概括
对烧伤患者来说,预测息性输出管术后的生存率至关重要. 较高的顺序性器官衰竭评估 (SOFA) 评分和离子间隙与在烧伤单位内口后一小时内死亡有关.
科学领域:
- 关键护理医学 关键护理医学
- 烧伤手术 烧伤手术
- 抚慰性护理是一种缓解性护理.
背景情况:
- 息式输出管允许自然死亡,当呼吸机支持与患者的目标相矛盾时.
- 预测输出管术后的生存时间有助于家庭咨询,息治疗和器官捐献.
- 在烧伤患者的息性输出管术后影响短期生存的因素仍未得到充分研究.
研究的目的:
- 为了确定与死亡相关的因素,在一个小时内,在成人烧伤病房患者的息性输出管.
- 在这个人群中提供数据,以改善预后和治疗目标讨论.
主要方法:
- 成年烧伤患者接受息性输出管的回顾性病例对照研究 (7/10/2015 - 6/30/2023).
- 收集了人口统计数据,并发症,损伤细节和临床参数.
- 利用单变量和多变量分析来确定1小时内死亡的预测因素,包括序列器官衰竭评估 (SOFA) 评分和离子间隙.
主要成果:
- 在47名患者中,25人 (53.2%) 在息性输出管术后一小时内死亡.
- 单变量分析显示,早期死亡与较高的SOFA分数,离子间隙和其他临床标志物之间存在关联.
- 多变量分析发现,较高的SOFA分数 (OR=2.851) 和离子间隙 (OR=1.687) 是一个小时内死亡的重要预测因素.
结论:
- 在成人烧伤患者中,较高的SOFA分数和离子间隙独立地与缓解性拔后一小时内死亡有关.
- 这些发现可以帮助临床医生制定护理讨论和预后的目标.
- 进一步的研究可能会完善预测模型,在烧伤人群中缓解性输出管术后的死亡时间.
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