Non-pneumatic Anti-Shock Garment for Obstetrical Hemorrhage

非气动产科出血抗休克服

• 批准号: 7491914
• 负责人: SUELLEN MILLER
• 金额: $ 5.08万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-06-01 至 2012-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7491914
• 关键词: Accounting; Address; Adopted; Adverse effects; Age; Blood Transfusion; California; Caring; Case Series; Cessation of life; Childbirth; Control Groups; Developed Countries; Developing Countries; Devices; Discipline of obstetrics; Dyspnea; Effectiveness; Egypt; Emergency Medical Technicians; Emergency Situation; Evidence based practice; Experimental Designs; First Aid; Goals; Health; Health care facility; Healthcare Systems; Hemorrhage; Hemorrhagic Shock; Home environment; Hospital Referrals; Hospitals; Hour; Hypovolemic Shock; Hypoxia; Hysterectomy; Incidence; International; Intervention; Life; Maternal Health; Maternal Mortality; Morbidity - disease rate; Nausea and Vomiting; Neoprene; Operative Surgical Procedures; Outcome; Output; Patients; Pilot Projects; Postpartum Hemorrhage; Pregnancy; Primary Health Care; Procedures; Randomized; Recovery; Research; Research Design; Resources; Respiratory distress; Resuscitation; San Francisco; Satellite Hospitals; Shock; Statistically Significant; Teaching Hospitals; Testing; Time; United States; Universities; Urine; Woman; Zambia; Zimbabwe; burden of illness; design; disability; disability-adjusted life years; experience; improved; mortality; pilot trial; reproductive

The global burden of disease from maternal morbidity and mortality is great. Pregnancy and childbirth related illnesses are the second leading cause of lost years of healthy life among women of reproductive,age in developing countries, accounting for nearly 31 million disability adjusted life years (DALYS) lost annually. The largest contributor to maternal death and disability is obstetric hemorrhage. Due to long delays in obtaining definitive therapy, such as blood transfusion or surgery, women bleed to death at home, in primary health care centers, and on the road to referral hospitals. The goal of this proposed study is to reduce maternal mortality and severe morbidities from obstetric hemorrhage and hypovolemic shock by the first-aid application of the non-pneumatic anti-shock garment (NASG). The NASG is a reusable neoprene and Velcro lower-body compression suit, which has, outside of a few pilot trials, never been used in the developing world. Although it has been shown to reverse shock and to decrease blood loss in obstetric patients in one pre/post pilot study in Egypt, there is, currnelty, no evidence that its use will decrease maternal mortality or morbidity. In an era of evidence-based practice, maternity health care systems in low resource settings cannot adopt new procedures without approval of international donors and health experts. The primary aim of this study is to demonstrate, using a cluster-randomized controlled design, that application of the NASG at the primary health care level before transfer to a referral hospital will decrease extreme adverse outcomes, i.e.,maternal mortality and severe maternal morbidity. The primary aim of this project is to test the effectiveness of the NASG as first aid hemorrhage and shock management to) 1) reduce the incidence of maternal mortality, 2) reduce the incidence of severeacute maternal morbidity, 3) reduce the incidence of emergency hysterectomies, and 4) reduce the time to recovery from hemorrhagic shock. The secondary aim is to to examine negative effects that might be associated with NASG use, including 1) decreased urine output, 2) hypoxia, dyspnea, or other forms of respiratory distress, 3) increased intraoperative bleeding, and/or 4) nausea and vomiting in the women who receive the NASG.

产妇发病率和死亡率造成的全球疾病负担很大。妊娠和分娩 相关疾病是导致育龄妇女失去健康寿命的第二大原因 在发展中国家，每年损失的伤残调整生命年将近3100万年。 产妇死亡和残疾的最大原因是产科出血。由于长时间的延误， 获得明确的治疗，如输血或手术，妇女在家中失血过多致死，在初级 医疗保健中心，以及前往转诊医院的路上。这项拟议研究的目标是减少 急救产科出血和低血容量性休克的孕产妇死亡率和严重发病率 非气动防震服(NASG)的应用。NASG是一种可重复使用的氯丁橡胶 尼龙搭扣下半身压缩套装，除了几次试点试验外，从未在 发展中世界。尽管它已被证明可以逆转休克和减少产科失血 在埃及的一项试点研究中，目前没有证据表明它的使用量会减少 产妇死亡率或发病率。在一个循证实践的时代，产妇保健系统处于低水平 未经国际捐助者和卫生专家批准，资源设置不能采用新程序。 这项研究的主要目的是证明，使用整群随机对照设计， 转到转诊医院之前，在初级卫生保健层面应用NASG的人数将会减少 极端的不良后果，即产妇死亡率和严重的产妇发病率。 该项目的主要目的是测试NASG作为急救失血和休克的有效性 管理：1)减少孕产妇死亡率，2)减少严重急性死亡的发生率 产妇发病率，3)减少紧急子宫切除术的发生率，4)减少 从失血性休克中恢复。第二个目标是检查可能存在的负面影响 与NASG的使用有关，包括1)尿量减少，2)缺氧，呼吸困难，或其他形式的 呼吸窘迫，3)术中出血增加，和/或4)恶心和呕吐 收到NASG。