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三级护理医院重症监护病房收治的危重症患者舒张功能障碍的患病率:一项前瞻性观察研究。

Prevalence of Diastolic Dysfunction in Critically Ill Patients Admitted to Intensive Care Unit from a Tertiary Care Hospital: A Prospective Observational Study.

作者信息

Luitel Bipin, Senthilnathan Muthapillai, Cherian Anusha, Suganya Srinivasan, Adole Prashant S

机构信息

Department of Anaesthesiology & Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.

Department of Anaesthesiology and Critical Care, Sri Venkateshwaraa Medical College Hospital and Research Centre, Puducherry, India.

出版信息

Indian J Crit Care Med. 2024 Sep;28(9):832-836. doi: 10.5005/jp-journals-10071-24794. Epub 2024 Aug 31.

Abstract

AIM

Critically ill individuals may have left ventricular diastolic dysfunction (LVDD) which can prolong their intensive care unit (ICU) stay. The purpose of this study was to determine the prevalence of LVDD in critically ill adult patients requiring mechanical ventilation in ICU, the effect of LVDD on 28-day survival, and weaning from mechanical ventilation.

METHODOLOGY

A total of 227 adults who had been on mechanical ventilation for more than 48 hours in an ICU were recruited for this study. The study's parameters were recorded on the third day of mechanical ventilation using a low-frequency phased array probe. A simplified definition of LVDD in critically ill adults was utilized to determine the presence or absence of LVDD. Weaning failure and 28-day mortality were noted.

RESULTS

The prevalence of LVDD in adults requiring mechanical ventilation in the ICU was found to be 35.4% ( = 79). Patients with LVDD had the odds of having a 28-day mortality increase by 7.48 (95% CI: 3.24-17.26, < 0.0001). Patients with LVDD had the odds of having weaning failure increase by 5.37 (95% CI: 2.17-13.26, = 0.0003).

CONCLUSION

Measures should be taken to detect critically ill adults with LVDD with systolic dysfunction or heart failure with preserved ejection fraction early so that their fluid balance, myocardial contractility, and afterload can be optimized to minimize their morbidity and mortality.

HIGHLIGHTS

Critically ill adults with LVDD may have adverse outcomes. Hence, protocol should be in place for diagnosing LVDD early in critically ill adults thereby, measures can be taken to minimize morbidity in those patients.

HOW TO CITE THIS ARTICLE

Luitel B, Senthilnathan M, Cherian A, Suganya S, Adole PS. Prevalence of Diastolic Dysfunction in Critically Ill Patients Admitted to Intensive Care Unit from a Tertiary Care Hospital: A Prospective Observational Study. Indian J Crit Care Med 2024;28(9):832-836.

摘要

目的

危重症患者可能存在左心室舒张功能障碍(LVDD),这可能延长其在重症监护病房(ICU)的住院时间。本研究的目的是确定ICU中需要机械通气的成年危重症患者LVDD的患病率、LVDD对28天生存率的影响以及机械通气撤机情况。

方法

本研究共纳入227名在ICU接受机械通气超过48小时的成年人。在机械通气第三天使用低频相控阵探头记录研究参数。采用危重症成年患者LVDD的简化定义来确定是否存在LVDD。记录撤机失败和28天死亡率。

结果

在ICU需要机械通气的成年人中,LVDD的患病率为35.4%(n = 79)。LVDD患者28天死亡率增加的几率为7.48(95%可信区间:3.24 - 17.26,P < 0.0001)。LVDD患者撤机失败增加 的几率为5.37(95%可信区间:2.17 - 13.26,P = 0.0003)。

结论

应采取措施尽早发现患有收缩功能障碍或射血分数保留的心力衰竭的成年危重症LVDD患者,以便优化其液体平衡、心肌收缩力和后负荷,将其发病率和死亡率降至最低。

要点

患有LVDD的成年危重症患者可能会出现不良后果。因此,应制定方案以便在成年危重症患者中早期诊断LVDD,从而采取措施将这些患者的发病率降至最低。

如何引用本文

Luitel B, Senthilnathan M, Cherian A, Suganya S, Adole PS. 三级医院重症监护病房收治的危重症患者舒张功能障碍的患病率:一项前瞻性观察研究。《印度重症监护医学杂志》2024;28(9):832 - 836。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58ee/11443266/d684b6029789/ijccm-28-832-g001.jpg

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