一项由护士主导的方案，使用脉搏血氧饱和度仪使机械通气患者从有害氧浓度中撤离呼吸机。

A nurse-directed protocol using pulse oximetry to wean mechanically ventilated patients from toxic oxygen concentrations.

作者信息

Rotello L C, Warren J, Jastremski M S, Milewski A

机构信息

Program in Multidisciplinary Critical Care, University Hospital, SUNY Health Science Center, Syracuse 13210.

出版信息

Chest. 1992 Dec;102(6):1833-5. doi: 10.1378/chest.102.6.1833.

DOI:10.1378/chest.102.6.1833

PMID:1446498

Abstract

The usual method of weaning mechanically ventilated patients from high FIO2 in our ICU, in which housestaff ordered all ventilator changes in an unstandardized manner (control group), was compared to a nurse-directed protocol that used a single arterial blood gas (ABG) analysis and multiple pulse oximetry measurements. The protocol required an ABG to be obtained upon the initiation of intubation/mechanical ventilation, followed by pulse oximetry measurements obtained in accordance with a standardized timetable. Decreases in FIO2 were guided by these results. It was concluded that a nurse-directed oxygen weaning protocol utilizing a combination of a single ABG and multiple pulse oximetry measurements was safe, reduced the need for ABGs, and decreased the duration of patient exposure to toxic oxygen concentrations.

摘要

在我们的重症监护病房（ICU）中，将机械通气患者从高氧浓度（FIO2）撤机的常规方法（由住院医师以非标准化方式下令进行所有呼吸机参数调整，为对照组）与一种由护士主导的方案进行了比较。该方案使用单次动脉血气（ABG）分析和多次脉搏血氧饱和度测量。该方案要求在插管/机械通气开始时进行一次ABG检测，随后按照标准化时间表进行脉搏血氧饱和度测量。根据这些结果指导降低FIO2。得出的结论是，一种由护士主导的氧疗撤机方案，结合单次ABG和多次脉搏血氧饱和度测量，是安全的，减少了ABG检测的需求，并缩短了患者暴露于有毒氧浓度的时间。