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言语-语言病理学家在儿科重症监护病房的参与。

Speech-language pathologist involvement in the paediatric intensive care unit.

机构信息

Department of Otolaryngology & Communication Enhancement, Boston Children's Hospital, Boston, MA, USA.

Department of Rehabilitation, Akron Children's Hospital, Akron, OH, USA.

出版信息

Int J Speech Lang Pathol. 2024 Oct;26(5):674-681. doi: 10.1080/17549507.2023.2244195. Epub 2023 Oct 1.

DOI:10.1080/17549507.2023.2244195
PMID:37778370
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10982122/
Abstract

PURPOSE

To measure the prevalence of speech-language pathologist (SLP) involvement and associated trends for critically ill children in United States (US) paediatric intensive care units (PICU) through secondary analysis of the Prevalence of Acute Rehab for Kids in the PICU (PARK-PICU) study data.

METHOD

A secondary analysis of cross-sectional point prevalence study conducted over 1 day in 82 US PICUs. Data collected included SLP presence, patients' age, length of stay, medical interventions, aetiology, admission data, Glasgow Coma Scale scores, staffing involvement, and family presence.

RESULT

Among 961 patients, 82 were visited by an SLP on the study day for a prevalence of 8.5%. Most visits were for children <3 years old. The odds of SLP involvement were lower for children who were 7-12 years old (vs. age 0-2; adjusted odds ratio [aOR] 0.28; 95% CI 0.1-0.8), were mechanically ventilated via endotracheal tube (vs. room air; aOR 0.02; 95% CI 0.005-0.11), or had mild or severe disability (mild vs. no disability; aOR 0.34; 95% CI 0.16-0.76 and severe vs. no disability; aOR 0.39; 95% CI 0.17-0.90). Concurrent physical and/or occupational therapy involvement was associated with higher odds of SLP involvement (aOR 3.6; 95% CI 2.1-6.4).

CONCLUSION

SLP involvement is infrequent in US PICUs. PICU teams should be educated about the scope of SLP practice, to support communication and oral feeding needs during early recovery from critical illness.

摘要

目的

通过对儿科重症监护病房(PICU)中儿童急性康复治疗的患病率(PARK-PICU)研究数据进行二次分析,测量美国(US)PICU 中言语语言病理学家(SLP)参与的情况和相关趋势。

方法

对 82 个美国 PICU 中进行的为期 1 天的横断面时点患病率研究进行二次分析。收集的数据包括 SLP 的存在、患者的年龄、住院时间、医疗干预、病因、入院数据、格拉斯哥昏迷量表评分、人员配备和家庭参与情况。

结果

在 961 名患者中,有 82 名患者在研究日接受了 SLP 的访问,患病率为 8.5%。大多数就诊发生在<3 岁的儿童中。SLP 参与的可能性对于 7-12 岁的儿童较低(与 0-2 岁相比;调整后的优势比 [aOR] 0.28;95%置信区间 [CI] 0.1-0.8),通过气管内插管进行机械通气(与室内空气相比;aOR 0.02;95%CI 0.005-0.11),或有轻度或重度残疾(轻度 vs. 无残疾;aOR 0.34;95%CI 0.16-0.76 和重度 vs. 无残疾;aOR 0.39;95%CI 0.17-0.90)。同时进行物理和/或职业治疗与 SLP 参与的可能性较高相关(aOR 3.6;95%CI 2.1-6.4)。

结论

美国 PICU 中 SLP 的参与率较低。PICU 团队应接受有关 SLP 实践范围的教育,以支持从危重病中早期康复期间的沟通和口服喂养需求。