宫脊髓损伤患者的后急性呼吸机断奶和出院结果:回顾性分析
Casey Fenger1, Brian W Locke2, James Barker3
1Drs. Fenger, Flis, Park, and Rosenbluth are affiliated with Department of Physical Medicine and Rehab, University of Utah, Salt Lake City, Utah, USA.
大多数椎脊髓损伤 (CSCI) 患者在康复期间实现呼吸机独立. 关键的里程碑,如白天断奶和脱,发生在几周的康复过程中,较低的受伤水平和较年轻的年龄预测了更好的结果.
科学领域:
- 神经学 神经学
- 肺部病理学 肺部病理学
- 康复医学 康复医学 康复医学
背景情况:
- 椎脊髓损伤 (CSCI) 经常导致呼吸道肌肉衰弱,需要长时间的机械通风和气管切除术.
- 在急性CSCI护理中,呼吸机断里程碑的时间表没有得到充分的记录.
研究的目的:
- 评估白天呼吸机断奶的速率和时间,从侵入性通风中解放出来,在接受康复的CSCI成年人中进行脱.
- 探索断奶里程碑和排泄倾向之间的关联.
主要方法:
- 在康复中心 (2015-2022) 对39名需要持续机械通风的成年CSCI患者的回顾性分析.
- 应用标准化呼吸机断奶协议.
- 追踪到关键里程碑的时间 (白天断奶,解放,解锁).
- 里程碑成就和出院结果的预测者使用细灰竞争风险和比例赔率物流回归分析.
主要成果:
- 76%的人在白天实现了断奶 (中位数为20天),62%的解放 (中位数为23天),48%的断 (中位数为36天).
- 较低级别的伤害 (C5-C8) 与更高的断奶/解禁率 (OR 5.54) 相关联.
- 年龄较大与重症监护室出院相关 (OR 0.68/十年);脱管治疗增加了家庭出院的几率 (OR 22.84).
结论:
- 大多数接受机械通风的CSCI患者在康复期间实现了部分或完全的呼吸独立.
- 这些重要的断奶里程碑通常在康复过程中达到几周.
更多相关视频
05:09Author Spotlight: Neuromotor Control and Recovery of Diaphragm Function Following Cervical Spinal Hemisection in Rats
Published on: June 14, 2024
09:37Evaluation of Respiratory Muscle Activation Using Respiratory Motor Control Assessment RMCA in Individuals with Chronic Spinal Cord Injury
Published on: July 19, 2013
相关概念视频
Tracheostomy Decannulation
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...
Endotracheal Tube Extubation
Procedure
Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals....
Mechanical Ventilation III: Noninvasive Ventilation
Noninvasive Positive-Pressure Ventilation...
Discharge Summary Forms
Here's a detailed look at the key components and guidelines for preparing a discharge summary:
Ventilatory Modes
There are three ventilatory modes: full support, partial support, and spontaneous. These are described below.
Full Support Modes
Full support modes include controlled mechanical ventilation, continuous mandatory...
Mechanical Ventilation II: Invasive Ventilation
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...
