Khan Raymond M, Aljuaid Maha, Aqeel Hanan, Aboudeif Mohammed M, Elatwey Shaimaa, Shehab Rajeh, Mandourah Yasser, Maghrabi Khalid, Hawa Hassan, Khalid Imran, Qushmaq Ismael, Latif Asad, Chang Bickey, Berenholtz Sean M, Tayar Sultan, Al-Harbi Khloud, Yousef Amin, Amr Anas A, Arabi Yaseen M
Department of Intensive Care, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.
Department of Critical Care, International Extended Care Center, Jeddah, Saudi Arabia.
Ann Thorac Med. 2017 Jan-Mar;12(1):11-16. doi: 10.4103/1817-1737.197765.
Over the past decade, there have been major improvements to the care of mechanically ventilated patients (MVPs). Earlier initiatives used the concept of ventilator care bundles (sets of interventions), with a primary focus on reducing ventilator-associated pneumonia. However, recent evidence has led to a more comprehensive approach: The ABCDE bundle (Awakening and Breathing trial Coordination, Delirium management and Early mobilization). The approach of the Comprehensive Unit-based Safety Program (CUSP) was developed by patient safety researchers at the Johns Hopkins Hospital and is supported by the Agency for Healthcare Research and Quality to improve local safety cultures and to learn from defects by utilizing a validated structured framework. In August 2015, 17 Intensive Care Units (ICUs) (a total of 271 beds) in eight hospitals in the Kingdom of Saudi Arabia joined the CUSP for MVPs (CUSP 4 MVP) that was conducted in 235 ICUs in 169 US hospitals and led by the Johns Hopkins Armstrong Institute for Patient Safety and Quality. The CUSP 4 MVP project will set the stage for cooperation between multiple hospitals and thus strives to create a countrywide plan for the management of all MVPs in Saudi Arabia.
在过去十年中，机械通气患者（MVPs）的护理有了重大改善。早期的举措采用了呼吸机护理集束（一系列干预措施）的概念，主要侧重于减少呼吸机相关性肺炎。然而，最近的证据促使人们采取更全面的方法：ABCDE集束（唤醒与呼吸试验协调、谵妄管理和早期活动）。基于综合病房的安全计划（CUSP）方法由约翰霍普金斯医院的患者安全研究人员开发，并得到医疗保健研究与质量局的支持，以改善当地的安全文化，并通过使用经过验证的结构化框架从缺陷中吸取教训。2015年8月，沙特阿拉伯王国八家医院的17个重症监护病房（ICU）（共271张床位）加入了由约翰霍普金斯阿姆斯特朗患者安全与质量研究所牵头、在美国169家医院的235个ICU中开展的针对机械通气患者的CUSP（CUSP 4 MVP）。CUSP 4 MVP项目将为多家医院之间的合作搭建平台，从而努力制定一项沙特阿拉伯全国范围内所有机械通气患者管理计划。
