Department of Obstetrics and Gynaecology, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa.
Department of Obstetrics and Gynaecology, Icesi University and Fundacion Valle del Lili, Cali, Colombia.
Int J Gynaecol Obstet. 2019 Jul;146(1):29-35. doi: 10.1002/ijgo.12828. Epub 2019 May 15.
Patients at risk of organ dysfunction or with established organ dysfunction should be referred to central or tertiary-level hospitals. However, even in central hospitals, intensive care unit (ICU) beds are often unavailable, which may contribute to maternal deaths. One pragmatic solution is to establish obstetric critical care units (OCCUs) in the labor wards of central hospitals; however, specific guidance on how to do this is limited. In addition, globally applicable standards of care are lacking, with uncertainty regarding who should lead obstetric critical care. In this article the specific OCCU infrastructure, equipment and human resources required to establish such units in central hospitals in low- and middle-income countries are described in sufficient detail for easy replication. Admission and discharge guidelines and operational recommendations that include quality indicators are also provided.
有器官功能障碍风险或已发生器官功能障碍的患者应转至中心或三级医院。然而，即使在中心医院，重症监护病房（ICU）床位也常常供不应求，这可能导致产妇死亡。一个切实可行的解决方案是在中心医院的产房设立产科重症监护病房（OCCU）；然而，关于如何设立此类病房的具体指导有限。此外，全球适用的护理标准也有所欠缺，对于谁应该领导产科重症护理存在不确定性。本文详细描述了在中低收入国家的中心医院建立产科重症监护病房所需的具体 OCCU 基础设施、设备和人力资源，以便于复制。还提供了包括质量指标在内的入院和出院指南以及操作建议。
