集束化策略在机械通气患者中的应用效果评价

The application effects of ABCDEF bundle care in ICU patients with mechanical ventilation

目的探讨集束化策略在机械通气患者中的应用效果。方法采用前瞻性研究方法,选取2017年12月—2018年12月入住深圳市某医院ICU行机械通气的70例患者,随机分为试验组与对照组,每组35例。试验组采取集束化策略,对照组采取常规措施,观察10 d,分析比较两组谵妄发生率、机械通气时长、镇静镇痛剂用量、非计划性拔管率、病死率、ICU住院天数及费用的差异。结果试验组谵妄发生率、机械通气时长、镇静镇痛剂用量、ICU住院天数及费用低于对照组,差异有统计学意义(P<0.05);非计划性拔管率、病死率两组比较,差异无统计学意义(P>0.05)。结论集束化策略能有效预防或减少谵妄发生,缩短机械通气时长,减少镇静镇痛剂用量,改善疾病预后,且安全有效、经济可行。

Objective To implement and evaluate application effects of ABCDEF bundle care in mechanically ventilated patients in intensive care unit(ICU). Methods The prospective randomized trial was conducted in ICU of our hospital from December 2017 and March 2019 in 70 mechanically ventilated ICU patients. Patients meeting inclusion criteria were randomly allocated into an observation group(n=35) and a control group(n=35). The control group received the conventional treatment,while the observation group was implemented with ABCDEF bundle care.The duration of intervention lasted 10 days. The incidences of delirium,duration of mechanical ventilation,the dosage of sedatives and analgesics,the unplanned extubation rate,mortality,the length of ICU stay,and expenses were analyzed and compared in 2 groups. Results The outcomes in the observation group were associated with lower likelihood(P<0.05) of 5 outcomes,namely incidence of delirium,duration of mechanical ventilation,the dosage of sedatives and analgesics length of ICU stay,and expenses. There were no significant differences in unplanned extubation rate,mortality between 2 groups(P>0.05). Conclusion ABCDEF bundle care showed clinically significant and meaningful improvements in outcomes including delirium,duration of mechanical ventilation,the dosage of sedatives and analgesics. It improved prognosis of ventilated ICU patients. ABCDEF bundle provides a safe,effective,economical and feasible strategy for ICU patients with mechanical ventilation.