氧合器更换的体外循环模拟训练意义

Oxygenator change: the value of cardiopulmonary bypass simulation training

目的通过对体外循环氧合不良及氧合器更换进行模拟训练,旨在规范体外循环中氧合不良的处理流程、氧合器更换的操作流程,从而提高体外循环团队对于氧合器故障的处理能力。方法 8名具备1年以上体外循环临床经验的体外循环学员参与本模拟训练,包括首次训练及1月后的重复训练。通过设计体外循环中氧合不良的场景,指导老师带领学员共同讨论氧合不良的处理流程,并训练学员更换氧合器。记录各学员氧合器更换所需时间,并对学员的临床思维、操作技术及交流互动各方面的表现进行综合评分。结果与首次训练相比,1个月后重复训练后,体外循环学员的综合评分显著提高[(4.63±0.52)vs(3.0±0.76),P<0.05],氧合器更换所需时间显著缩短[(152.4±18.8)s vs(381.0±70.1)s,P<0.05]。结论体外循环模拟训练有助于规范体外循环氧合不良的处理流程和氧合器更换的操作步骤,降低氧合器更换所需要的时间,提高团队处理氧合器故障的能力。

Objective The simulation training of oxygenation failure and oxygenator change was conducted to standardize theprocess of handling oxygenation failure and oxygenator change during cardopulmonary bypass（CPB）, and to improve the ability of theperfusion team to dealing with this situation.Methods Eight trainees with at least one year experience of CPB were enrolled, inclu-ding the first time training and re-training 1 month later. Setting the scenario of oxygenation failure, the instructor led the team discus-sion to identify the most appropriate management of this emergency. The time of oxygenator change of each trainee was recored and acomprehensive score was given according to their performance of each aspects including clinical thinking, operative technique and com-munication.Results With the first trainingand enhancement 1 month later, comprehensive scores of the CPB trainees were improvedsignificantly（4.63±0.52 vs 3.0±0.76,P〈0.05）, and the time needed for oxygenator change was shortened（152.4±18.8 vs 381.0±70.1,P〈0.05）.Conclusion The simulation training of CPB is beneficial to standardize the process of oxygenation failure and oxygenatorchange, shorten the time of oxygenator change, and improve the ability of the CPB team in dealing with the oxygenator failure emergency.