构建和验证一个风险预测模型,用于机械通风的儿科患者的呼吸机相关肺炎
Linxi He1, Dong Ma1, Yuanyuan Fu1
1Department of Paediatric Intensive Care Unit, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
Journal of nursing management
|November 6, 2025
概括
这项研究确定了机械通风 (MV) 儿童呼吸机相关肺炎 (VAP) 的关键风险因素. 一个经过验证的预测模型有助于针对性护理的早期VAP风险分层.
科学领域:
- 儿科重症监护医学 儿科重症监护医学
- 传染病流行病学 传染病流行病学
- 护理科学 护理科学
背景情况:
- 机械通风 (MV) 对重症儿科患者至关重要,但存在风险.
- 呼吸机相关肺炎 (VAP) 是机械呼吸的儿童的严重并发症.
- 识别风险因素和开发预测模型对于VAP预防至关重要.
研究的目的:
- 在接受机械通风的儿科患者中识别VAP的独立风险因素.
- 在这个人群中开发和验证VAP风险的预测模型.
- 引导精确的护理干预措施,以预防VAP.
主要方法:
- 在儿科重症监护室 (PICU) 接受MV的儿科患者的回顾性分析.
- 二元物流回归用于识别独立的VAP风险因素.
- 使用R软件开发和验证风险预测模型.
主要成果:
- 缺乏早期肠道营养,MV的持续时间,内吸频率,中央静脉导管和抗生素类型是显著的VAP风险因素 (p <0.05).
- 预测模型显示出强大的区分能力,ROC-AUC为0.870 (衍生) 和0.761 (验证).
- 该模型在两个队列中都得到了良好的校准 (霍斯默-莱梅肖测试,p > 0.05).
结论:
- 一个经过验证的风险预测模型有效地对机械通风儿童的VAP风险进行了分层.
- 早期识别高风险患者使得量身定制的护理策略成为可能.
- 针对可修改的风险因素可能会降低儿科患者的VAP发病率.
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