Katsukawa Hajime, Ota Kohei, Liu Keibun, Morita Yasunari, Watanabe Shinichi, Sato Kazuhiro, Ishii Kenzo, Yasumura Daisetsu, Takahashi Yo, Tani Takafumi, Oosaki Hitoshi, Nanba Tomoya, Kozu Ryo, Kotani Toru
Department of Scientific Research, Japanese Society for Early Mobilization, 1-2-12-2F Kudan-kita, Chiyoda-ku, Tokyo 102-0073, Japan.
Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan.
J Clin Med. 2021 Jun 13;10(12):2607. doi: 10.3390/jcm10122607.
The aim of this study is to clarify the incidence and risk factors of patient-related safety events (PSE) in situations limited to intubated patients in which active mobilization, such as sitting on the edge of the bed/standing/walking, was carried out. A multi-center retrospective observational study was conducted at nine hospitals between January 2017 and March 2018. The safety profiles and PSE of 87 patients were analyzed. PSE occurred in 10 out of 87 patients (11.5%) and 13 out of 198 sessions (6.6%). The types of PSE that occurred were hypotension (8, 62%), heart rate instability (3, 23%), and desaturation (2, 15%). Circulation-related events occurred in 85% of overall cases. No accidents, such as line/tube removal or falls, were observed. The highest incidence of PSE was observed during the mobilization level of standing (8 out of 39 sessions, 20.5%). The occurrence of PSE correlated with the highest activity level under logistic regression analysis. Close vigilance is required for intubated patients during active mobilization in the standing position with regard to circulatory dynamics.
本研究的目的是阐明在仅限于进行诸如坐在床边/站立/行走等主动活动的插管患者的情况下，患者相关安全事件（PSE）的发生率和风险因素。2017年1月至2018年3月期间，在九家医院开展了一项多中心回顾性观察研究。对87例患者的安全状况和PSE进行了分析。87例患者中有10例（11.5%）发生PSE，198次活动中有13次（6.6%）发生PSE。发生的PSE类型为低血压（8例，62%）、心率不稳定（3例，23%）和血氧饱和度下降（2例，15%）。85%的总体病例发生了与循环相关的事件。未观察到诸如管路拔除或跌倒等事故。在站立活动水平期间观察到PSE的发生率最高（39次活动中有8次，20.5%）。在逻辑回归分析中，PSE的发生与最高活动水平相关。对于站立位主动活动期间的插管患者，需要密切关注循环动力学。
