实施拔管检查表可降低拔管失败率。
Decreasing failed extubations with the implementation of an extubation checklist.
机构信息
University of Texas at Austin Dell Medical School, USA; Dell Seton Medical Center at the University of Texas, Department of Trauma Services, USA.
Dell Seton Medical Center at the University of Texas, Department of Trauma Services, USA.
出版信息
Am J Surg. 2019 Jun;217(6):1072-1075. doi: 10.1016/j.amjsurg.2019.02.028. Epub 2019 Mar 5.
BACKGROUND
Failed extubation has been shown to increase ICU stay, transfers to rehabilitation facilities, and mortality. The purpose of this study was to assess the differences in rates of failed extubation before and after implementation of an extubation checklist.
METHODS
We performed a retrospective study from January 2013-April 2017 on adult trauma patients (age 18-89) who were admitted to the ICU and required mechanical ventilation. Patients were grouped before and after implementation of an extubation checklist and compared.
RESULTS
A total of 993 patients were included in this study. After checklist implementation, significantly fewer patients required reintubation compared to those prior to checklist (7% vs 3%, p = 0.005). There was no difference in mortality (20% vs 21%, p = 0.54) or hospital length of stay between the two groups (16 days vs 15 days, p = 0.16).
CONCLUSION
Our study reveals that implementing an extubation checklist is associated with fewer failed extubations.
背景
已证实，拔管失败会增加 ICU 住院时间、转往康复机构的几率和死亡率。本研究旨在评估在实施拔管核对表前后，拔管失败的发生率的差异。
方法
我们对 2013 年 1 月至 2017 年 4 月期间入住 ICU 并需要机械通气的成年创伤患者（年龄 18-89 岁）进行了回顾性研究。患者在实施拔管核对表前后分组并进行比较。
结果
本研究共纳入 993 例患者。与实施核对表前相比，实施后需要再次插管的患者明显减少（7% vs 3%，p=0.005）。两组间死亡率（20% vs 21%，p=0.54）或住院时间（16 天 vs 15 天，p=0.16）均无差异。
结论
我们的研究表明，实施拔管核对表与降低拔管失败率相关。
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