心脏骤停后控制温度的实践模式和趋势:一项多专业调查
Casey T Carr1, Melody B Eckert2, Nilan Bhakta3
1Nazih Zuhdi Transplant Institute, Specialty Critical Care and Acute Circulatory Support Service, INTERIS Baptist Medical Center, Oklahoma City, OK 73112, USA.
医生在心脏骤停后控制温度的做法有很大差异,受专业和机构协议的影响,而不是像TTM2试验这样的新兴证据. 需要标准化的途径,以便在心脏骤停后提供一致的护理.
科学领域:
- 临界护理医学 临界护理医学
- 神经学 神经学
- 紧急医疗 紧急医疗
背景情况:
- 建议在心脏骤停后进行温度控制,但实践的变化仍然存在.
- 相互矛盾的证据和试验解释导致不一致的临床实施.
- 了解医生的观点对于将护理与不断变化的证据保持一致至关重要.
研究的目的:
- 评估国际医生对心脏骤停后控制温度的看法.
- 描述使用模式,理解神经损伤,以及新文献的影响.
- 确定影响温度目标选择和实践的因素.
主要方法:
- 一个由39项组成的基于网络的调查分发给了重症监护,神经病学和急诊医学医生.
- 该调查评估了人口统计,温度控制实践和最近试验的解释.
- 用描述性统计数据分析了471名医生的反应.
主要成果:
- 针对性温度管理 (TTM) 经常是基于指导方针和机构协议启动的.
- 最常见的温度目标是36°C;对TTM2试验的认识很高,但实践变化有限.
- 医生的专业,心脏骤停量和实践设置影响了温度目标选择.
结论:
- 心脏骤停后的温度控制实践和理由存在显著的异质性.
- 机构协议对实施有很大的影响,往往超过新出现的证据.
- 建议采用标准化,基于证据的途径,以减少变化,提高护理的一致性.
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