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急性呼吸窘迫综合征患者临床糖皮质激素使用的影响因素:工作经验、教育背景、职称和医院级别对重症监护病房医生的影响。

Effects of the working experience, educational background, professional titles, and hospital grades of intensive care unit doctors on clinical glucocorticoid use in acute respiratory distress syndrome.

机构信息

Department of Critical Care Medicine, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.

Medical Security Bureau of Yinzhou District, Ningbo, Zhejiang, China.

出版信息

Medicine (Baltimore). 2022 Mar 11;101(10):e29021. doi: 10.1097/MD.0000000000029021.

Abstract

Although glucocorticoids are commonly used for patients with acute respiratory distress syndrome in the intensive care unit, the exact attitudes of different intensive care unit (ICU) doctors about glucocorticoid usage are largely unknown. Herein, we investigated the practice of glucocorticoid application for acute respiratory distress syndrome (ARDS) by ICU doctors in China. Questionnaires were developed and sent to ICU doctors at 45 hospitals to perform statistics and analysis. ICU doctors with more working experience and professional titles had more knowledge of ARDS. Glucocorticoids were more likely to be used for ARDS caused by chemical inhalation. Doctors with longer working experience, better educational background, and higher professional titles used fewer glucocorticoids. In addition, 97.2%of the doctors considered using methylprednisolone or hydrocortisone first, 50.9% used glucocorticoids within 24hours of onset, and 37.1% insisted that steroid therapy should last 3 to 5days. Although ICU doctors with more working experience and professional titles have a better understanding of glucocorticoid use in ARDS, the majority of clinical practices and attitudes are similar among different doctors regardless of working experience, educational background, professional titles, or hospital grades.

摘要

虽然糖皮质激素在重症监护病房(ICU)中常用于治疗急性呼吸窘迫综合征(ARDS)患者,但不同 ICU 医生对糖皮质激素使用的确切态度在很大程度上尚不清楚。在此,我们调查了中国 ICU 医生应用糖皮质激素治疗急性呼吸窘迫综合征(ARDS)的情况。我们制定了问卷并分发给 45 家医院的 ICU 医生进行统计分析。具有更多工作经验和职称的 ICU 医生对 ARDS 的了解更多。糖皮质激素更有可能用于化学吸入引起的 ARDS。工作经验更长、教育背景更好、职称更高的医生使用的糖皮质激素更少。此外,97.2%的医生认为应首先使用甲泼尼龙或氢化可的松,50.9%的医生在发病后 24 小时内使用糖皮质激素,37.1%的医生坚持认为类固醇治疗应持续 3 至 5 天。尽管具有更多工作经验和职称的 ICU 医生对 ARDS 中糖皮质激素的使用有更好的了解,但无论工作经验、教育背景、职称或医院级别如何,大多数临床实践和态度在不同医生之间相似。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d97/8913106/492484ce86cd/medi-101-e29021-g001.jpg

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