针对性轻镇静策略在开放腹部管理中的可行性:一项回顾性研究
Junichi Fukushima1, Kyohei Miyamoto1, Mami Shibata1
1Department of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama, JPN.
Cureus
|September 2, 2025
概括
在非创伤性条件下进行开放腹部治疗的有针对性的光镇静是可行的和安全的. 这种方法有助于早期的机械通风断奶和ICU排放,显示出潜在的临床益处.
科学领域:
- 危急护理医学
- 外科重症监护
- 麻醉学
背景情况:
- 开放腹部管理 (OAM) 越来越多地用于非创伤性疾病,如胃肠道缺血.
- 对OAM的最佳镇静策略,特别是较轻的镇静,仍然不清楚.
- 这项研究评估了针对OAM患者的轻度镇静方法的可行性.
研究的目的:
- 评估针对性轻度镇静策略的可行性 (Richmond刺激和镇静量表 [RASS] 0~2) 在接受OAM的非创伤患者中.
- 为了比较轻度镇静队伍和常规镇静队伍之间的镇静深度和结果.
- 在OAM期间确定轻度镇静的安全性和潜在的临床益处.
主要方法:
- 在ICU接受OAM的非创伤患者的回顾性研究.
- 在特定的队列中实施有针对性的轻度镇静策略 (RASS 0至-2).
- 主要结论:轻度镇静的发生率和普罗波剂量 (mg/kg/h).
主要成果:
- 在目标队列中达到84%的轻度镇静,而在常规队列中达到41%.
- 在较轻的镇静剂组中,普罗波的平均剂量较低 (1.07 mg/ kg/ h与1. 30 mg/ kg/ h).
- 镇静剂较轻的患者经历了更快的机械通风断奶 (P=0. 015) 和更早的ICU出院 (P=0. 013).
- 由于不良事件,没有必要进行突发腹部检查.
结论:
- 对非创伤性OAM患者来说,有针对性的光镇静是可行的,也是安全的.
- 这一策略与改善的临床结果有关,包括更早地从机械通风和ICU中释放.
- 需要进一步的前性多中心研究来证实这些发现.
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