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通过自动重新定向干预预防重症成人谵妄——一项试点随机对照试验。

Delirium prevention in critically ill adults through an automated reorientation intervention - A pilot randomized controlled trial.

作者信息

Munro Cindy L, Cairns Paula, Ji Ming, Calero Karel, Anderson W McDowell, Liang Zhan

机构信息

University of South Florida College of Nursing, 12901 Bruce B. Downs Blvd, MDC 22, Tampa, FL 33612-4766, USA.

University of South Florida College of Nursing, 12901 Bruce B. Downs Blvd, MDC 22, Tampa, FL 33612-4766, USA.

出版信息

Heart Lung. 2017 Jul-Aug;46(4):234-238. doi: 10.1016/j.hrtlng.2017.05.002. Epub 2017 Jun 9.

Abstract

OBJECTIVES

Explore the effect of an automated reorientation intervention on ICU delirium in a prospective randomized controlled trial.

BACKGROUND

Delirium is common in ICU patients, and negatively affects outcomes. Few prevention strategies have been tested.

METHODS

Thirty ICU patients were randomized to 3 groups. Ten received hourly recorded messages in a family member's voice during waking hours over 3 ICU days, 10 received the same messages in a non-family voice, and 10 (control) did not receive any automated reorientation messages. The primary outcome was delirium free days during the intervention period (evaluated by CAM-ICU). Groups were compared by Fisher's Exact Test.

RESULTS

The family voice group had more delirium free days than the non-family voice group, and significantly more delirium free days (p = 0.0437) than the control group.

CONCLUSIONS

Reorientation through automated, scripted messages reduced incidence of delirium. Using identical scripted messages, family voice was more effective than non-family voice.

摘要

目的

在一项前瞻性随机对照试验中探讨自动重新定向干预对重症监护病房(ICU)谵妄的影响。

背景

谵妄在ICU患者中很常见,并且对预后有负面影响。很少有预防策略经过测试。

方法

30名ICU患者被随机分为3组。10名患者在3个ICU日的清醒时间内每小时收到一条家庭成员声音录制的信息,10名患者收到非家庭成员声音的相同信息,10名(对照组)患者未收到任何自动重新定向信息。主要结局是干预期间无谵妄天数(通过CAM-ICU评估)。通过Fisher精确检验对各组进行比较。

结果

家庭成员声音组的无谵妄天数多于非家庭成员声音组,且显著多于对照组(p = 0.0437)。

结论

通过自动编写的信息进行重新定向可降低谵妄的发生率。使用相同的编写信息时,家庭成员声音比非家庭成员声音更有效。

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