Du Jinlei, Chengcong Nie, Wu Xiaoling
Zigong Fourth People's Hospital, Sichuan, PR China.
Ann Med Surg (Lond). 2024 Jan 5;86(3):1426-1432. doi: 10.1097/MS9.0000000000001695. eCollection 2024 Mar.
This study proposed to explore individual management mode for patients with subglottic secretion drainage.
Randomly chosen within the hospital ICU 68 patients from 7 April to 15 June 2023, all the patients randomly assigned to the control group or observation group, and control group adopts the model of intermittent drainage management, observation group based on the volume of subglottic secretion in patients with individualized management, and then analysis the two groups of patients clinical trial results.
The clinical trial results showed that there were statistically significant differences (<0.05) between the control group and the observation group in the incidence of tube blockage events (11 vs. 2), average diurnal pumping frequency (9 vs. 7, 5 vs. 4) between the two groups and the patient satisfaction scores (6 vs. 7), In the partial mucosa injure (22 vs 19) and VAP (5 vs. 1) there were no statistically significant difference (>0.05). Although there was no statistically significant difference (>0.05) in the average aspiration volume (12.68±3.41 vs. 12.19±2.68, 8 vs. 8) between the two groups, but the management mode of the observation group indicated that based on patient secretion volume was more consistent with the characteristics of the body's diurnal metabolic differences, because there was a big difference between the average total amount of daytime and nighttime suction between the two groups.
Individualized management based on the volume of subglottic secretions produced by patients can further optimize the airway management of patients and reduce the risk of adverse events of subglottic secretions aspiration.
本研究旨在探索声门下分泌物引流患者的个体化管理模式。
于2023年4月7日至6月15日在医院重症监护病房随机选取68例患者,将所有患者随机分为对照组和观察组,对照组采用间歇性引流管理模式,观察组根据患者声门下分泌物量进行个体化管理,然后分析两组患者的临床试验结果。
临床试验结果显示,对照组与观察组在堵管事件发生率(11例 vs. 2例)、两组间平均日间抽吸频率(9次 vs. 7次,5次 vs. 4次)以及患者满意度评分(6分 vs. 7分)方面存在统计学显著差异(<0.05),在部分黏膜损伤(22例 vs. 19例)和呼吸机相关性肺炎(VAP,5例 vs. 1例)方面无统计学显著差异(>0.05)。虽然两组间平均抽吸量(12.68±3.41 vs. 12.19±2.68,8次 vs. 8次)无统计学显著差异(>0.05),但观察组的管理模式表明基于患者分泌物量更符合机体昼夜代谢差异特点,因为两组间日间和夜间平均总吸量差异较大。
基于患者产生的声门下分泌物量进行个体化管理可进一步优化患者气道管理,降低声门下分泌物误吸不良事件风险。