神经重症监护中的治疗限制决定:暂停或取消维持生命的措施
Isabella Carvalho Ankerstjerne1, Anne-Sophie Worm Fenger1, Markus Harboe Olsen1
1Department of Neuroanaesthesiology, The Neuroscience Centre, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
Acta anaesthesiologica Scandinavica
|February 22, 2026
概括
对四分之一的神经重症监护病人的治疗限制决定 (TLD) 已被做出. 与在神经临床护理中停止治疗相比,暂停维持生命治疗与更高的存活率有关.
科学领域:
- 神经科学是一个神经科学.
- 关键护理医学 关键护理医学
- 临床研究 临床研究
背景情况:
- 在神经重症监护中,治疗限制决定 (TLD) 往往不区分扣留和撤回.
- 了解TLD之间的差异对于患者的护理和结果至关重要.
研究的目的:
- 调查在神经ICU中接受维持生命治疗的患者的比例与停止治疗的比例.
- 分析这些决定与30天死亡率之间的关联.
主要方法:
- 成年神经临界病患者的回顾性观察队列研究 (2019年7月-2022年2月).
- 将其分类为完全待遇,保留或撤销组.
- 使用考克斯比例风险模型和受限生存时间的30天死亡率的比较.
主要成果:
- 对7.2%的患者 (保留) 和17.9%的患者 (撤回) 进行了TLD.
- 扣留组:年龄较大,并发症指数较高;退出组:较低的GCS,较高的APACHE II分数.
- 30天死亡率:32% (保留),98% (撤销),8.1% (完全治疗).
结论:
- 大约四分之一的神经ICU患者患有TLD.
- 接受暂停治疗的患者的存活率明显高于接受暂停治疗的患者.
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