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基于烧伤脱机评估方案的护理干预对机械通气成功脱机的影响:一项随机对照临床试验

The Effect of Nursing Interventions Based on Burns Wean Assessment Program on Successful Weaning from Mechanical Ventilation: A Randomized Controlled Clinical Trial.

作者信息

Sepahyar Maryam, Molavynejad Shahram, Adineh Mohammad, Savaie Mohsen, Maraghi Elham

机构信息

Nursing Care Research Center in Chronic Diseases, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

出版信息

Iran J Nurs Midwifery Res. 2021 Jan 18;26(1):34-41. doi: 10.4103/ijnmr.IJNMR_45_20. eCollection 2021 Jan-Feb.

Abstract

BACKGROUND

The effective design and implementation of the nursing interventions to evaluate the patients' readiness for ventilator weaning will reduce their connection time to the ventilator and the complications of their connection to it. This study was conducted to examine the effect of nursing interventions based on the Burns Wean Assessment Program (BWAP) on successful weaning from Mechanical Ventilation (MV).

MATERIALS AND METHODS

In this clinical trial, 70 patients undergoing MV in the Intensive Care Units (ICUs) of Golestan Hospital (Ahvaz, Iran) in 2018 were randomly assigned to intervention and control groups. The nursing interventions designed based on BWAP were implemented on the patients in the intervention group, who were later weaned from the device according to this program. The recorded data included demographic information, BWAP score, vital signs, and laboratory values, which were analyzed using the Pearson correlation coefficient, Chi-Square, Fisher, and Mann-Whitney U tests.

RESULTS

There was a statistically significant and inverse correlation between the BWAP score and the MV duration such that a high BWAP score was associated with a shorter MV time ( = 0.041). Also, the mean number of re-intubation ( = 0.001) and the number of re-connection to the ventilator in the intervention group were significantly lower ( = 0.005).

CONCLUSIONS

The results showed that nurses' assessment of patient's readiness for weaning from MV based on this tool and designed nursing care reduced the duration of MV, re-intubation, and re-connection.

摘要

背景

评估患者撤机准备情况的护理干预措施的有效设计与实施,将减少患者使用呼吸机的时间及其相关并发症。本研究旨在探讨基于伯恩斯撤机评估程序(BWAP)的护理干预对机械通气(MV)成功撤机的影响。

材料与方法

在这项临床试验中,2018年在伊朗阿瓦士戈勒斯坦医院重症监护病房(ICU)接受机械通气的70例患者被随机分为干预组和对照组。基于BWAP设计的护理干预措施应用于干预组患者,随后根据该程序使其撤机。记录的数据包括人口统计学信息、BWAP评分、生命体征和实验室值,使用Pearson相关系数、卡方检验、Fisher检验和Mann-Whitney U检验进行分析。

结果

BWAP评分与机械通气持续时间之间存在统计学上显著的负相关,即BWAP评分越高,机械通气时间越短(P = 0.041)。此外,干预组再次插管的平均次数(P = 0.001)和重新连接呼吸机的次数显著更低(P = 0.005)。

结论

结果表明,护士基于该工具对患者撤机准备情况的评估以及设计的护理措施减少了机械通气的持续时间、再次插管和重新连接的情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c434/8074739/89439c35c141/IJNMR-26-34-g001.jpg

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