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多学科检查表对有创机械通气持续时间和重症监护病房住院时间的影响。

Impact of a multidisciplinary checklist on the duration of invasive mechanical ventilation and length of ICU stay.

作者信息

Barcellos Ruy de Almeida, Chatkin José Miguel

机构信息

. Programa de Pós-Graduação em Medicina e Ciências da Saúde, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre (RS) Brasil.

出版信息

J Bras Pneumol. 2020 Mar 27;46(3):e20180261. doi: 10.36416/1806-3756/e20180261. eCollection 2020.

Abstract

OBJECTIVE

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.

METHODS

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.

RESULTS

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).

CONCLUSIONS

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.

摘要

目的

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。

方法

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。

结果

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)。

结论

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d0a/7572285/be288c69fdf4/1806-3713-jbpneu-46-03-e20180261-ch1.jpg

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