患者特征对重症监护患者体位诱导的血液学和生化变异的影响
Shaughn Nalezinski1,2, Carol A Carman1, Juan U Rojo1
1Department of Clinical Laboratory Sciences, School of Health Professions, University of Texas Medical Branch, Galveston, TX, United States.
15分钟将患者的姿势从仰卧变为直立,会显著影响重症监护室 (ICU) 的实验室测试结果. 这种简单的调整可以提高ICU患者常规血液和生化检测的准确性.
科学领域:
- 临床实验室科学 临床实验室科学
- 关键护理医学 关键护理医学
- 生理学 生理学 生理学
背景情况:
- 标准的实验室参考范围是基于门诊患者,不考虑水静压变化.
- 重症监护室 (ICU) 的患者通常是卧卧的,可能会扭曲实验室测试结果.
- 患者姿势对ICU环境中的实验室值的影响尚不清楚.
研究的目的:
- 评估患者姿势对ICU患者常规血液学和生物化学实验室测试的影响.
- 为了确定姿势的变化是否会影响关键的实验室参数.
- 评估实验室结果中与姿势相关的变化的临床相关性.
主要方法:
- 在单个ICU中进行了前性,主体内设计研究.
- 血液样本从血液动力学稳定的成年ICU患者中收集,首先是在卧卧的状态下,然后在直立状态下15分钟后.
- 对配对的血液样本进行了分析,以检测常规血液学和生物化学测试值的差异.
主要成果:
- 观察到与姿势相关的红细胞计数,白细胞计数,血红蛋白,血红素,,二氧化碳,阴离子间隙,专,性酸酶和总胆红素 (P ≤ .05) 的显著差异.
- 发现了动脉样硬化和白细胞计数/血红素;肝病/败血症和红细胞分布宽度;和心血管疾病;葡萄糖和创伤;总蛋白质和内出血之间的相关性.
- 这些发现强调了姿势对各种关键实验室参数的影响.
结论:
- 保持直立15分钟可提高ICU患者常规实验室检测的准确性.
- 将短暂的直立定位期纳入瘤切除方案可以提高诊断可靠性.
- 姿势调整是一种简单而有效的方法,可以优化临床试验的准确性,在重症患者.
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