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医生教育以及食管压力和跨肺压参数的可得性对涉及呼吸机管理的临床决策的影响。

Impact of physician education and availability of parameters regarding esophageal pressure and transpulmonary pressure on clinical decisions involving ventilator management.

作者信息

Norisue Yasuhiro, Ashworth Lonny, Naito Takaki, Kataoka Jun, Takeuchi Muneyuki, Usami Sunao, Takada Junko, Fujitani Shigeki

机构信息

Department of Pulmonary and Critical Care Medicine, Tokyo Bay Urayasu Ichikawa Medical Center, Chiba, Japan.

Department of Respiratory Care, Boise State University, Boise, ID, USA.

出版信息

J Crit Care. 2017 Oct;41:112-118. doi: 10.1016/j.jcrc.2017.04.021. Epub 2017 Apr 18.

DOI:10.1016/j.jcrc.2017.04.021
PMID:28514715
Abstract

PURPOSE

This study investigated the effects of physician education and the availability of P and P data on physicians' decisions regarding ventilator management during specific simulated clinical conditions.

MATERIALS AND METHODS

The study was a prospective, before-after study using a case scenario-based questionnaire and a case simulator device comprising an Avea ventilator and an artificial lung and esophagus, which was connected to a Series 1101 Electronic Breathing Simulator. The 99 physicians participating in the study were provided with five simulated cases with on-time ventilator graphics without P and P and completed a questionnaire on decisions they would make regarding ventilator management of the cases. Then, after receiving instruction on P and P, they were given the same cases along with ventilator graphics that included P and P.

RESULTS

After receiving instruction and data on P and P, statistically significant numbers of physicians changed their answers regarding ventilator management decisions in all five cases.

CONCLUSIONS

Providing education and data for P and P had a significant effect on physician decisions regarding ventilator management in simulated cases. The use of case scenario-based education with simulator devices for physicians may hasten worldwide understanding and clinical application of P and P.

摘要

目的

本研究调查了医师教育以及压力-时间(P-T)数据的可用性对医师在特定模拟临床情况下关于呼吸机管理决策的影响。

材料与方法

本研究是一项前瞻性前后对照研究,使用基于病例场景的问卷以及一个病例模拟器设备,该设备包括一台Avea呼吸机、一个人工肺和食管,并连接到1101系列电子呼吸模拟器。参与研究的99名医师收到了五个没有P-T数据的实时呼吸机图形模拟病例,并完成了一份关于他们对这些病例进行呼吸机管理决策的问卷。然后,在接受了关于P-T的指导后,他们收到了相同的病例以及包含P-T的呼吸机图形。

结果

在接受了关于P-T的指导和数据后,在所有五个病例中,有统计学意义数量的医师改变了他们关于呼吸机管理决策的答案。

结论

提供P-T的教育和数据对医师在模拟病例中关于呼吸机管理的决策有显著影响。对医师使用基于病例场景的教育和模拟器设备可能会加速全球对P-T的理解和临床应用。

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Impact of physician education and availability of parameters regarding esophageal pressure and transpulmonary pressure on clinical decisions involving ventilator management.医生教育以及食管压力和跨肺压参数的可得性对涉及呼吸机管理的临床决策的影响。
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引用本文的文献

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Should we titrate peep based on end-expiratory transpulmonary pressure?-yes.我们应该根据呼气末跨肺压来滴定呼气末正压(PEEP)吗?——应该。
Ann Transl Med. 2018 Oct;6(19):390. doi: 10.21037/atm.2018.06.35.