Al-Subu Awni M, Rehder Kyle J, Ofori-Amanfo George, Turner David A
Division of Pediatric Critical Care Medicine, Department of Pediatrics, American Family Children's Hospital, University of Wisconsin Hospitals and Clinics, Madison, Wisconsin, United States.
Division of Pediatric Critical Care, Department of Pediatrics, The Children's Hospital at Montefiore, Bronx, New York, United States.
J Pediatr Intensive Care. 2018 Sep;7(3):135-146. doi: 10.1055/s-0038-1623480. Epub 2018 Jan 28.
To describe the current use of noninvasive monitoring compared with traditional invasive monitoring in Pediatric Critical Care Medicine (PCCM) accredited fellowship programs in the United States. A web-based survey with the primary aim of describing the utilization of noninvasive monitoring compared with invasive monitoring was distributed to PCCM program directors (PDs) at the 64 accredited fellowship training programs. Questions focused on demographics and the utilization of invasive and noninvasive monitoring for specific patient populations and disease states. Forty-two (66%) PDs responded to the survey. Capnography and near-infrared spectroscopy (NIRS) were the most commonly reported noninvasive monitoring technology. Arterial and central venous catheters were widely used. Other invasive monitoring devices were used sparingly. Despite widespread use of both invasive and noninvasive monitoring in academic pediatric critical care units across the United States, there is significant variability in the use of noninvasive monitoring compared with invasive monitoring. Further investigation is needed to define the standard of care for the use of noninvasive monitors as practitioners attempt to optimize care while minimizing risks and complications.
描述在美国儿科学重症医学(PCCM)认可的 fellowship 项目中,与传统有创监测相比,无创监测的当前使用情况。一项主要目的是描述无创监测与有创监测使用情况的基于网络的调查,被分发给了 64 个认可的 fellowship 培训项目中的 PCCM 项目主任(PDs)。问题集中在人口统计学以及针对特定患者群体和疾病状态的有创和无创监测的使用情况。42 位(66%)PDs 回复了该调查。二氧化碳描记法和近红外光谱法(NIRS)是最常被报告的无创监测技术。动脉导管和中心静脉导管被广泛使用。其他有创监测设备使用较少。尽管在美国学术性儿科重症监护病房中,有创和无创监测都被广泛使用,但与有创监测相比,无创监测的使用存在显著差异。随着从业者试图在将风险和并发症降至最低的同时优化护理,需要进一步调查以确定使用无创监测仪的护理标准。