Toomtong Patiparn, Vorakitpokatorn Putipannee
Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
J Med Assoc Thai. 2002 Sep;85 Suppl 3:S1000-9.
Notice of all surgical patients who need access to Siriraj post-anesthetic intensive care unit (ICU) must be given to the ICU in advance by the surgical team. However, there are some patients who present unexpectedly, and we would like to evaluate this unplanned ICU admission as a quality control.
We performed a self-reported study of the patients who were categorized as unplanned for ICU admission over a six-month period from June 1st to November 30th, 2001. We attempted to quantify these patients into small groups in order to learn what the reasons were, where they came from, and how big the anesthesia-related reasons can be.
There were 520 admissions to the ICU during study period, and of those 80 were unplanned patients. The major source of these patients is from the operating theaters, followed by the recovery rooms and surgical wards. There were 65 patients admitted because of the cardiopulmonary problems, while 13 patients were admitted for close observations; surgical complications made up another 8 patients. Overall there were 36 unplanned patients because of anesthesia-associated complications.
These results indicate that the patients who are admitted to the post-anesthetic ICU without prior planning can provide insights of ICU resource management, and the standards of perioperative management in the operating theatres. It definitely offers an opportunity to implement changes in our anesthetic practice. We will continue to monitor the impact of this important indicator.
所有需要进入诗里拉吉麻醉后重症监护病房（ICU）的外科手术患者，手术团队必须提前通知ICU。然而，有些患者会意外前来，我们希望将这种非计划内的ICU收治情况作为质量控制进行评估。
我们对2001年6月1日至11月30日这六个月期间被归类为非计划内进入ICU的患者进行了一项自我报告研究。我们试图将这些患者分成小组，以便了解原因、他们来自何处以及与麻醉相关的原因占多大比例。
研究期间有520例患者入住ICU，其中80例为非计划内患者。这些患者的主要来源是手术室，其次是恢复室和外科病房。因心肺问题入院的患者有65例，因密切观察入院的有13例；手术并发症导致另外8例入院。总体而言，有36例非计划内患者是由于麻醉相关并发症。
这些结果表明，未经事先计划而入住麻醉后ICU的患者能够为ICU资源管理以及手术室围手术期管理标准提供见解。这无疑为我们改变麻醉实践提供了机会。我们将继续监测这一重要指标的影响。
