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接受体外膜氧化治疗的患者的压力损伤:三级中心的经验
Halide Oğuş1, A Ece Altınay1, Fatih Yiğit2
1Department of Anaesthesiology, University of Health Sciences, Koşuyolu High Specialization Training and Research Hospital, Istanbul, Turkey.
Journal of wound care
|August 13, 2025
概括
压力损伤 (PI) 是常见的重症监护患者在体外膜氧化 (ECMO). 年龄和ECMO持续时间是COVID-19相关ARDS治疗期间开发新的PI的关键风险因素.
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
- 传染性疾病 传染性疾病
背景情况:
- 压力损伤 (PIs) 对重症患者来说是一个重大问题,特别是那些需要体外膜氧化 (ECMO) 患者.
- 与COVID-19相关的急性呼吸道应急综合征 (ARDS) 通常需要长时间的ECMO支持,增加患者对PI的脆弱性.
研究的目的:
- 确定患有COVID-19相关ARDS的ECMO治疗患者的压力损伤 (PI) 的发生率和风险因素.
主要方法:
- 一项对78名患有严重COVID-19相关ARDS的患者的回顾性评估,在2020年4月至2022年1月期间接受静脉ECMO.
- 使用布拉登尺度评估PI风险,并按照国家压力损伤咨询小组的指导方针进行PI分期.
- 根据2019年临床实践指南的压力预防和治疗来管理患者.
主要成果:
- 在78名患者中,30.8%的患者在ECMO上转移到ICU时已经存在PI.
- 在ECMO平均持续时间为48.5天的44.4%的患者 (24/54) 中出现了新的PI,主要是第二阶段.
- 新PI发展的独立预测因素包括晚年 (OR: 1.103) 和更长的ECMO持续时间 (OR: 1.048).
结论:
- 专注的重症监护病房团队遵守PI预防的既定临床实践指南至关重要.
- 实施严格的PI预防协议可以显著减少长期ECMO支持患者压力损伤的发生率.
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