Suppr超能文献

危重病肿瘤血液病患者的高价值医疗:目前我们了解多少?

High-value care for critically ill oncohematological patients: what do we know thus far?

机构信息

Discipline of Anaesthesiology, Pain and Intensive Care, Escola Paulista de Medicina, Universidade Federal de São Paulo - São Paulo (SP), Brazil.

AC Camargo Cancer Center - São Paulo (SP), Brazil.

出版信息

Crit Care Sci. 2023 Mar 1;35(1):84-96. doi: 10.5935/2965-2774.20230405-en.

Abstract

The number of patients with cancer requiring intensive care unit admission is increasing around the world. The improvement in the pathophysiological understanding of this group of patients, as well as the increasingly better and more targeted treatment options for their underlying disease, has led to a significant increase in their survival over the past three decades. Within the organizational concepts, it is necessary to know what adds value in the care of critical oncohematological patients. Practices in medicine that do not benefit patients and possibly cause harm are called low-value practices, while high-value practices are defined as high-quality care at relatively low cost. In this article, we discuss ten domains with high-value evidence in the care of cancer patients: (1) intensive care unit admission policies; (2) intensive care unit organization; (3) etiological investigation of hypoxemia; (4) management of acute respiratory failure; (5) management of febrile neutropenia; (6) urgent chemotherapy treatment in critically ill patients; (7) patient and family experience; (8) palliative care; (9) care of intensive care unit staff; and (10) long-term impact of critical disease on the cancer population. The disclosure of such policies is expected to have the potential to change health care standards. We understand that it is a lengthy process, and initiatives such as this paper are one of the first steps in raising awareness and beginning a discussion about high-value care in various health scenarios.

摘要

全球需要入住重症监护病房的癌症患者数量正在增加。这组患者的病理生理学理解的提高,以及针对其基础疾病的治疗选择越来越多且更具针对性,使得他们在过去三十年中的存活率显著提高。在组织概念中,有必要了解在重症肿瘤血液病患者的护理中什么是增加价值的。对患者无益且可能造成伤害的医学实践称为低价值实践,而高价值实践则定义为高质量、低成本的护理。在本文中,我们讨论了癌症患者护理中具有高价值证据的十个领域:(1)入住重症监护病房的政策;(2)重症监护病房的组织;(3)低氧血症的病因学调查;(4)急性呼吸衰竭的管理;(5)中性粒细胞减少性发热的管理;(6)危重症患者的紧急化疗治疗;(7)患者和家属的体验;(8)姑息治疗;(9)重症监护病房工作人员的护理;以及(10)重症疾病对癌症患者群体的长期影响。这些政策的披露有望具有改变医疗保健标准的潜力。我们理解这是一个漫长的过程,而本文等倡议是提高认识和开始讨论各种卫生情况下的高价值护理的第一步。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15cd/10275311/90724c237984/ccsci-35-01-0084-g01.jpg

文献检索

告别复杂PubMed语法,用中文像聊天一样搜索,搜遍4000万医学文献。AI智能推荐,让科研检索更轻松。

立即免费搜索

文件翻译

保留排版,准确专业,支持PDF/Word/PPT等文件格式,支持 12+语言互译。

免费翻译文档

深度研究

AI帮你快速写综述,25分钟生成高质量综述,智能提取关键信息,辅助科研写作。

立即免费体验