Pan Mimi, Zhang Lizhong
Mimi Pan Department of Emergency, Wenzhou People's Hospital, Wenzhou City, Zhejiang Province 325000, P.R. China.
Lizhong Zhang Department of Emergency, Wenzhou People's Hospital, Wenzhou City, Zhejiang Province 325000, P.R. China.
Pak J Med Sci. 2024 Sep;40(8):1819-1824. doi: 10.12669/pjms.40.8.9506.
BACKGROUND & OBJECTIVE: Acute respiratory failure (ARF) is a life-threatening condition that necessitates intensive care and often results in high morbidity and mortality. Predictive nursing, combined with a risk early warning system, offers a proactive approach to patient care that could potentially improve outcomes in patients with ARF. However, the efficiency of this approach in intensive care settings is still unclear. This study aimed to analyze the effect of predictive nursing based on risk early warning system in patients with acute respiratory failure in intensive care unit (ICU) setting.
A retrospective cohort study included records of 368 patients admitted to ICU of a tertiary care hospital due to ARF from January 2021 to January 2023. Patients were divided into two groups based on the received care: standard care (control group, n=197) and predictive nursing care based on a risk early warning system (observation group, n=171). Data on demographics, clinical characteristics, complications, Acute Physiology, Age and Chronic Health Evaluation-II (APACHE-II) and Sequential Organ Failure Assessment (SOFA) scores, and duration of hospitalization were collected and analyzed.
The observation group exhibited significantly lower incidence of complications related to ventilator use and shorter durations of mechanical ventilation, ICU stay, and total hospitalization compared to the control group (p<0.001). Furthermore, patients in the observation group had significantly lower APACHE-II and SOFA scores and blood lactate levels at both one week and two weeks post-intervention.
Predictive nursing care based on a risk early warning system significantly improved clinical outcomes and reduced mortality rates in ICU patients with ARF. The results underscore the potential of integrating predictive nursing care into routine practice, thereby transforming the care paradigm for ICU patients with ARF. Future research should explore the applicability of predictive nursing for other clinical conditions and in various healthcare settings.
急性呼吸衰竭（ARF）是一种危及生命的疾病，需要重症监护，且常常导致高发病率和死亡率。预测性护理与风险预警系统相结合，为患者护理提供了一种积极主动的方法，有可能改善ARF患者的治疗结果。然而，这种方法在重症监护环境中的效率仍不明确。本研究旨在分析基于风险预警系统的预测性护理对重症监护病房（ICU）中急性呼吸衰竭患者的影响。
一项回顾性队列研究纳入了2021年1月至2023年1月因ARF入住三级护理医院ICU的368例患者的记录。根据接受的护理将患者分为两组：标准护理（对照组，n = 197）和基于风险预警系统的预测性护理（观察组，n = 171）。收集并分析了人口统计学、临床特征、并发症、急性生理学与慢性健康状况评分系统-II（APACHE-II）和序贯器官衰竭评估（SOFA）评分以及住院时间的数据。
与对照组相比，观察组呼吸机使用相关并发症的发生率显著降低，机械通气时间、ICU住院时间和总住院时间均缩短（p < 0.001）。此外，观察组患者在干预后1周和2周时的APACHE-II和SOFA评分以及血乳酸水平均显著降低。
基于风险预警系统的预测性护理显著改善了ICU中ARF患者的临床结局并降低了死亡率。结果强调了将预测性护理纳入常规实践的潜力，从而改变ICU中ARF患者的护理模式。未来的研究应探索预测性护理在其他临床情况和各种医疗环境中的适用性。
