Barcellos Ruy de Almeida, Chatkin José Miguel
. Programa de Pós-Graduação em Medicina e Ciências da Saúde, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre (RS) Brasil.
J Bras Pneumol. 2020 Mar 27;46(3):e20180261. doi: 10.36416/1806-3756/e20180261. eCollection 2020.
To assess the impact that implementing a checklist during daily multidisciplinary rounds has on the duration of invasive mechanical ventilation (IMV) and length of ICU stay.
This was a non-randomized clinical trial in which the pre-intervention and post-intervention duration of IMV and length of ICU stay were evaluated in a total of 466 patients, including historical controls, treated in three ICUs of a hospital in the city of Caxias do Sul, Brazil. We evaluated 235 and 231 patients in the pre-intervention and post-intervention periods, respectively. The following variables were studied: age; gender; cause of hospitalization; diagnosis on admission; comorbidities; the Simplified Acute Physiology Score 3; the Sequential Organ Failure Assessment score; days in the ICU; days on IMV; reintubation; readmission; in-hospital mortality; and ICU mortality.
After the implementation of the checklist, the median (interquartile range) for days in the ICU and for days on IMV decreased from 8 (4-17) to 5 (3-11) and from 5 (1-12) to 2 (< 1-7), respectively, and the differences were significant (p ≤ 0.001 for both).
The implementation of the checklist during daily multidisciplinary rounds was associated with a reduction in the duration of IMV and length of ICU stay among the patients in our sample.
评估在每日多学科查房期间实施检查表对有创机械通气（IMV）持续时间和重症监护病房（ICU）住院时间的影响。
这是一项非随机临床试验，在巴西南卡希亚斯市一家医院的三个ICU中，对总共466例患者（包括历史对照）的IMV干预前和干预后持续时间以及ICU住院时间进行了评估。我们分别在干预前期和干预后期评估了235例和231例患者。研究了以下变量：年龄；性别；住院原因；入院诊断；合并症；简化急性生理学评分3；序贯器官衰竭评估评分；在ICU的天数；IMV天数；再次插管；再次入院；院内死亡率；以及ICU死亡率。
实施检查表后，ICU住院天数和IMV天数的中位数（四分位间距）分别从8（4 - 17）天降至5（3 - 11）天，以及从5（1 - 12）天降至2（<1 - 7）天，差异均具有统计学意义（两者p≤0.001）。
在我们的样本中，每日多学科查房期间实施检查表与IMV持续时间缩短和ICU住院时间缩短相关。
