Department of Medicine, Graduate School of Biomedical Sciences, University of Massachusetts Medical School, Worcester, MA; Department of Anesthesiology, Graduate School of Biomedical Sciences, University of Massachusetts Medical School, Worcester, MA; Department of Surgery, Graduate School of Biomedical Sciences, University of Massachusetts Medical School, Worcester, MA; School of Medicine, and the Clinical and Population Health Research Program, Graduate School of Biomedical Sciences, University of Massachusetts Medical School, Worcester, MA.
Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD.
Chest. 2011 Nov;140(5):1232-1242. doi: 10.1378/chest.11-0718. Epub 2011 Aug 25.
Nationwide benchmarks representing current critical care practice for the range of ICUs are lacking. This information may highlight opportunities for care improvement and allows comparison of ICU practice data.
Data representing 243,553 adult admissions from 271 ICUs and 188 US nonfederal hospitals during 2008 were analyzed using the eICU Research Institute clinical practice database. Participating ICUs and hospitals varied widely regarding bed number, community size, academic status, geographic location, and organizational structure.
More than one-half of these critically ill adults were < 65 years old, and most patients returned to their homes after hospital discharge. Most patients were admitted from an ED, had a medical admission diagnosis, and received antimicrobial therapy. Intensive treatment was common, including 27% who received mechanical ventilation, 7.5% who were supported with noninvasive ventilation, 24.3% who were treated with vasoactive infusions, > 20% who received a blood product, and 4.4% who agreed to a care limitation order during their ICU stay. Forty percent of cases had a < 10% mortality risk and did not have an intensive treatment documented.
Admission to an ICU in 2008 involved active treatments that often included life support and counseling for those near the end of life and was associated with favorable outcomes for most patients.
缺乏代表当前重症监护实践范围的全国性基准。这些信息可能突出了改善护理的机会，并允许比较 ICU 实践数据。
使用 eICU 研究所在 2008 年期间从 271 个 ICU 和 188 家美国非联邦医院采集的 243,553 名成年患者的数据进行分析。参与的 ICU 和医院在床位数、社区规模、学术地位、地理位置和组织结构方面差异很大。
这些重症成年人中超过一半年龄<65 岁，大多数患者在出院后返回家中。大多数患者从急诊科入院，有医疗入院诊断，并接受了抗菌治疗。强化治疗很常见，包括 27%接受机械通气，7.5%接受无创通气支持，24.3%接受血管活性输注治疗，>20%接受血液制品治疗，4.4%在 ICU 期间同意接受护理限制医嘱。40%的病例死亡风险<10%，并且没有记录强化治疗。
2008 年 ICU 收治的患者接受了积极的治疗，这些治疗通常包括生命支持和对生命末期患者的咨询，并且大多数患者的预后良好。
