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影响心脏骤停后综合征患者标准化治疗质量的因素

Factors Influencing the Quality of Standardized Treatment for Patients with Post-Cardiac Arrest Syndrome.

作者信息

Lu Jing, Liu Lijun, Zhu Jianliang, Guo Xinying

机构信息

School of Public Health, Fudan University, Shanghai, China.

Department of Intensive Care Unit, Traditional Chinese Medicine of Kunshan, Nanjing University of Chinese Medicine, Suzhou, China.

出版信息

Korean Circ J. 2017 Jul;47(4):455-461. doi: 10.4070/kcj.2016.0437. Epub 2017 Jul 24.

Abstract

BACKGROUND AND OBJECTIVES

For the present study, we investigated the factors that influence the quality of standardized treatment for patients with post-cardiac arrest syndrome (PCAS) to improve the quality of PCAS treatment.

SUBJECTS AND METHODS

We collected data on patients with cardiac arrest (CA) who were admitted to the intensive care units (ICUs) of 11 hospitals-Class II Grade A or above-in Suzhou from January to October 2013. Indexes of standardized treatment were observed within 72 hrs of CA. We analyzed monitoring techniques, monitoring frequency, ICU human and material resources, and intensivists' knowledge of PCAS treatment to explore how those factors affected the management of patients with PCAS.

RESULTS

The bed/nurse ratio and the frequency with which core temperature was recorded correlated closely with the implementation of therapeutic hypothermia (TH) within 6 hrs of CA. The bed/doctor ratio and intensivists' knowledge about PCAS correlated closely with high-quality blood glucose control within 6 hrs of CA. Furthermore, the frequency with which core temperature was recorded was an independent factor influencing the quality of TH implementation, and the number times blood gas was analyzed was an independent factor influencing how well partial pressure of carbon dioxide was kept within the normal range in the 6 hrs after CA.

CONCLUSION

The frequency of core temperature measurements and the number of times blood gas is analyzed are the most important factors influencing the quality of standardized treatment for patients with PCAS.

摘要

背景与目的

在本研究中,我们调查了影响心脏骤停后综合征(PCAS)患者标准化治疗质量的因素,以提高PCAS的治疗质量。

对象与方法

我们收集了2013年1月至10月期间入住苏州11家二级甲等及以上医院重症监护病房(ICU)的心脏骤停(CA)患者的数据。在CA发生后72小时内观察标准化治疗指标。我们分析了监测技术、监测频率、ICU人力和物力资源以及重症医学专家对PCAS治疗的了解情况,以探讨这些因素如何影响PCAS患者的管理。

结果

病床/护士比例以及记录核心体温的频率与CA发生后6小时内治疗性低温(TH)的实施密切相关。病床/医生比例以及重症医学专家对PCAS的了解与CA发生后6小时内高质量的血糖控制密切相关。此外,记录核心体温的频率是影响TH实施质量的独立因素,而分析血气的次数是影响CA后6小时内二氧化碳分压维持在正常范围内情况的独立因素。

结论

核心体温测量频率和血气分析次数是影响PCAS患者标准化治疗质量的最重要因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a379/5537146/60749beb67bd/kcj-47-455-g001.jpg

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