Retrospective Analysis of an Interdisciplinary Ventilator Care Program Intervention on Survival of Infants with Ventilator-Dependent Bronchopulmonary Dysplasia.
Retrospective Analysis of an Interdisciplinary Ventilator Care Program Intervention on Survival of Infants with Ventilator-Dependent Bronchopulmonary Dysplasia.
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DOI：
10.1055/s-0036-1584897
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发表时间：
2017-01
影响因子：
2
通讯作者：
Baker CD
中科院分区：
文献类型：
--
作者：
Gien J;Kinsella J;Thrasher J;Grenolds A;Abman SH;Baker CD
严重支气管肺发育不良（BPD）的婴儿仍然依赖呼吸机的临床需求是复杂的，管理策略，优化生存和长期结果的争议。我们假设，致力于这一人群护理的跨学科呼吸机护理计划（VCP）将通过心肺护理和相关合并症的标准化方法、加强沟通和护理的连续性来改善生存率。对科罗拉多儿童医院新生儿重症监护室的患者进行了回顾性病历审查，这些患者在2000年至2013年期间接受了气管切开术。收集了两个时间段的数据：2000年至2005年和2006年至2013年，在VCP启动之前和之后。收集的呼吸机依赖性BPD婴儿的数据包括：胎龄（GA）、气管造口术时的年龄、呼吸严重程度评分（RSS;平均气道压[MAP] ×吸入氧分数[FiO 2]）、合并症、药物使用和死亡年龄。排除无严重BPD的气管切开患者。尽管没有差异，但VCP前后的GA、出生体重或发病率和出院存活率在实施VCP后从50%增加到85%（p < 0.05）。在第1阶段和第2阶段之间，全身性和吸入性类固醇使用以及粘液溶解剂使用存在差异。这些研究结果表明，采用跨学科方法护理呼吸机依赖性BPD的婴儿可以提高生存率。
The clinical needs of infants with severe bronchopulmonary dysplasia (BPD) that remain ventilator-dependent are complex, and management strategies that optimize survival and long-term outcomes controversial. We hypothesized that an interdisciplinary ventilator care program (VCP), committed to the care of this population will improve survival through standardized approaches to cardiopulmonary care and related comorbidities, enhanced communication, and continuity of care. Retrospective chart reviews were performed on patients at Children’s Hospital Colorado’s neonatal intensive care unit, who underwent tracheostomy placement between 2000 and 2013. Data were collected for two time periods: 2000 to 2005 and 2006 to 2013, before and after initiation of the VCP. Collected data on infants with ventilator-dependent BPD included: gestational age (GA), age at tracheostomy, respiratory severity score (RSS; mean airway pressure [MAP] × fraction of inspired oxygen [FiO2]), comorbidities, medication use, and the age of death. Tracheostomy patients without severe BPD were excluded. Despite no difference, pre and post VCP regarding GA, birth weight or morbidities and survival to discharge increased from 50% to 85% after implementation of the VCP (p < 0.05). Between period 1 and 2, there were differences in systemic and inhaled steroid use and mucolytic use. These findings suggest an interdisciplinary approach to the care of infants with ventilator-dependent BPD can improve survival.
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影响因子：
3.1
作者：
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通讯作者：
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DOI：
10.3109/14767058.2013.860438
发表时间：
2014-08-01
影响因子：
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作者：
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