ICU精准化液体信息管理系统的构建及应用研究

The construction and application of precise fluid volume management system in ICU

目的设计并开发基于多学科团队的ICU精准化液体信息管理系统并评价其应用效果。方法设计ICU精准化液体信息管理系统,包括出入量智能导入、全程预警提醒、闭环管理等功能。比较系统应用前后患者容量管理效果、出入量统计的准确性和时效性及团队成员满意度。结果患者第8小时血管外肺水指数(extravascular lung water index,EVLWI)从[10.00(7.82,16.27)]ml/kg降低至[8.05(6.50,11.80)]ml/kg(Z=2.413,P=0.015)。护士统计出入量时间从[5.00(3.00,7.00)]min降至[1.00(1.00,2.00)]min(Z=34.698,P<0.001)。医护人员对系统操作的简便性、液体管理准确性、预警功能、促进团队协作及总体满意度评分分别为(4.46±0.70)分、(4.06±0.77)分、(3.51±1.24)分、(4.31±0.76)分、(4.04±1.16)分。结论精准化液体信息管理系统提高了危重患者容量管理的安全性及医护人员液体管理的准确性、时效性,在危重患者精准化液体管理、风险预警提示及闭环沟通管理中发挥了重要作用。

Objective To design and develop a precise fluid volume management system for critically ill patients based on multidisciplinary teamwork and evaluate its application effects.Methods Design a precise fluid volume management system for critically ill patients,including intelligent input and output,full-process monitoring,early warning reminders,closed-loop management and etc.We compared the effect of patient volume management,the accuracy and timeliness of input and output calculation and satisfaction of team members before and after the application of the system.Results Extravascular lung water index(EVLWI)at the 8 th hour reduced from[10.00(7.82,16.27)]ml/kg to[8.05(6.50,11.80)]ml/kg(Z=2.413,P=0.015).The time for calculating the input and output decreased from[5.00(3.00,7.00)]min to[1.00(1.00,2.00)]min(Z=34.698,P<0.001).The scores of satisfactions on the ease of operation,the accuracy of fluid management,the early warning function,the promotion of team cooperation and the overall satisfaction by the medical staff were(4.46±0.70),(4.06±0.77),(3.51±1.24),(4.31±0.76),(4.04±1.16).Conclusion The precise fluid volume management system improved the safety of volume management for critically ill patients,the accuracy and timeliness of input output management.It played an important role in precise fluid management,risk warning and closed-loop communication management for critically ill patients.