引入长期输管关键病人的气管切除术共享决策的成果
Shu-Hung Kuo1, Chien-Wei Hsu2, Wei-Chun Huang2
1Department of Critical Medicine, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan; Graduate Institute of Clinical Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan; College of Medicine, School of Medicine, National Sun Yat-sen University, Kaohsiung City, Taiwan; School of Nursing, Fooyin University, Kaohsiung City, Taiwan.
Respiratory medicine
|October 11, 2025
概括
气管切除术的共享决策 (SDM) 增加了其使用,降低了危急患者的死亡率. SDM特别有利于那些患有呼吸道,神经肌肉或恶性疾病的人.
科学领域:
- 关键护理医学 关键护理医学
- 外科手术决策 - - 进行外科手术的决策
- 患者的治疗结果.
背景情况:
- 在台湾,气管切除术的应用不足.
- 长时间的输液管道对危急患者构成风险.
- 共享决策 (SDM) 可能会影响气管切除术的实践.
研究的目的:
- 调查SDM对气管切除术率和临床结果的影响.
- 评估SDM对需要长时间输管治疗的危急患者的影响.
- 评估SDM对死亡率和其他关键指标的影响.
主要方法:
- 对1464名患有呼吸衰竭的ICU患者进行了回顾性研究 (2017年4月至2023年4月).
- 倾向性得分匹配 (2:1) 来比较SDM和非SDM组.
- 分析气管切除率,死亡率,输入管到气管切除时间和其他结果.
主要成果:
- SDM与更高的气管切除率 (44.3%与30.9%) 和较低的住院死亡率 (15.7%与26.5%) 有关.
- 输入管到气管切除术的时间或其他临床结果没有显著差异.
- 在之前患有呼吸道,神经肌肉和恶性疾病的患者中,SDM的益处最大.
结论:
- 对气管切除术实施SDM与改善的临床结果有关.
- SDM对经历长时间输管治疗的重症监护患者产生积极影响.
- 共享决策增强了气管切除术患者护理途径.
相关概念视频
Tracheostomy Decannulation
1.2K
Tracheostomy decannulation is a significant milestone in the liberation of mechanically ventilated patients. Despite its importance, there is no universally accepted protocol for this procedure. This demands an evidence-based, individualized approach.
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...
1.2K
Endotracheal Tube Extubation
3.6K
Endotracheal tube extubation is a critical procedure in weaning patients from mechanical ventilation. It involves physically removing the oral or nasal endotracheal (ET) tube, marking the final step in liberating a patient from ventilatory support.
Procedure
Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals....
Procedure
Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals....
3.6K
Oxygen Delivering System III: Tracheostomy and T-piece
5.5K
Oxygen delivery is critical in clinical care, especially for patients with respiratory disorders or those undergoing surgical procedures. Various systems, such as tracheostomy and the T-piece, deliver oxygen to the lungs, ensuring adequate arterial oxygenation.
Tracheostomy
A tracheostomy is a surgically created opening (stoma) in the anterior part of the trachea. It is used to establish a patient airway, bypass an upper airway obstruction, simplify the removal of secretions, permit long-term...
Tracheostomy
A tracheostomy is a surgically created opening (stoma) in the anterior part of the trachea. It is used to establish a patient airway, bypass an upper airway obstruction, simplify the removal of secretions, permit long-term...
5.5K
Endotracheal Intubation II: Nursing Management
2.4K
Endotracheal intubation is a critical procedure that can be lifesaving for many patients with respiratory distress or failure. The role of nursing in managing endotracheal tubes is pivotal, as it involves pre-intubation preparation, assisting during the procedure, and post-extubation care.
1. Nursing Care of Patients Before Intubation
Before the endotracheal intubation procedure, nurses play an essential role in ensuring the process goes smoothly. The nurses must be familiar with intubation...
1. Nursing Care of Patients Before Intubation
Before the endotracheal intubation procedure, nurses play an essential role in ensuring the process goes smoothly. The nurses must be familiar with intubation...
2.4K
Tracheostomy Care I: Pre-procedural Steps
988
A tracheostomy is a surgical technique that involves making an incision in the neck to provide access to the trachea. It is frequently used in medical conditions such as airway obstruction and prolonged mechanical ventilation. Effective nursing management is crucial for the long-term success of a tracheostomy.
Required Equipment
The equipment necessary for tracheostomy care includes:
Required Equipment
The equipment necessary for tracheostomy care includes:
988
Endotracheal Intubation I: Procedure
7.4K
Endotracheal or ET intubation is a critical medical procedure used to secure a patient's airway, often in acute respiratory distress, apnea, upper airway obstruction, ineffective clearance of secretions, high risk for aspiration, or during general anesthesia.
The ET tube comprises various components, including a standard adaptor to attach a bag-valve-mask (BVM) or ventilator, a cuff, a pilot balloon, and radiopaque markings along its length to measure the insertion distance. The tube sizes...
The ET tube comprises various components, including a standard adaptor to attach a bag-valve-mask (BVM) or ventilator, a cuff, a pilot balloon, and radiopaque markings along its length to measure the insertion distance. The tube sizes...
7.4K


