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Sasa Rajsic1, Diana Morales Castro2, Kiran Shekar3
1Department of Anaesthesia and Intensive Care Medicine, Medical University Innsbruck, Innsbruck, Austria.
身体外生命支持 (ECLS) 需要仔细考虑患者选择和资源分配. 优先考虑具有现实的恢复潜力的干预措施,确保最佳的护理和价值.
科学领域:
- 临界护理医学 临界护理医学
- 医学伦理 医学伦理
- 卫生经济学 卫生经济学
背景情况:
- 身体外生命支持 (ECLS) 是一个复杂的,资源密集的干预,具有不断发展的应用.
- 与ECLS相关的高成本和长时间住院需要对其价值和适当使用进行批判性评估.
- 虽然经常讨论ECLS退出,但确定何时*不*启动ECLS同样重要.
研究的目的:
- 探索ECLS的适当和有价值的应用的关键考虑因素.
- 强调患者选择,基于证据的标准和ECLS护理持续重新评估的重要性.
- 将伦理考虑和息护理原则纳入ECLS的决策.
主要方法:
- 审查关于ECLS启动和管理的当前文献和临床实践.
- 在高成本重症监护干预的背景下,分析道德困境和资源管理.
- 在ECLS中讨论预后不确定性和预测工具的局限性.
主要成果:
- 最佳的ECLS护理取决于严格的患者选择和明确的,基于证据的标准.
- 预测的不确定性仍然是一个挑战,预测工具提供有限但有用的指导.
- 避免"通往无处的桥梁"需要优先考虑具有实现有意义恢复的现实潜力的干预措施.
结论:
- 通过在正确的时间向正确的患者提供正确的治疗,ECLS的价值得到最大化.
- 为了获得最佳的ECLS护理,平衡临床益处,道德责任和社会资源管理至关重要.
- 整合息护理和伦理框架可以提高关于ECLS启动和延续的决策.
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