手术后意外入住重症监护室:对临床结果的影响。

IF 2.3 3区 医学 Q2 ANESTHESIOLOGY
Current Opinion in Anesthesiology Pub Date : 2024-04-01 Epub Date: 2024-01-11 DOI:10.1097/ACO.0000000000001342
Gianmaria Cammarota, Edoardo De Robertis, Rachele Simonte
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引用次数: 0

摘要

综述目的:本综述旨在深入探讨术后意外入住重症监护病房(ICU)的原因、对临床结果的影响以及减轻医疗系统压力的潜在策略:术后意外入住重症监护室是由多种因素共同作用的结果,包括患者的临床状态、手术类型、重症监护室外的支持性护理和临床监测水平,以及意外发生的主要围手术期和术后并发症。鉴于多项观察性研究和近期随机临床试验的结果相互矛盾,术后意外入住重症监护室对临床结果的实际影响仍不确定。尽管如此,术后非计划入住重症监护室仍会对医院资源造成巨大压力。因此,应在医院政策中解决这一问题,目的是实施术前风险评估和患者评估、有效沟通、警惕监督和促进合作医疗。摘要:术后非计划入住 ICU 是一种多因素现象,给医疗系统造成了巨大负担,但对临床预后没有明显影响。因此,及早识别需要入住重症监护室的患者势在必行。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Unexpected intensive care unit admission after surgery: impact on clinical outcome.

Purpose of review: This review is focused on providing insights into unplanned admission to the intensive care unit (ICU) after surgery, including its causes, effects on clinical outcome, and potential strategies to mitigate the strain on healthcare systems.

Recent findings: Postoperative unplanned ICU admission results from a combination of several factors including patient's clinical status, the type of surgical procedure, the level of supportive care and clinical monitoring outside the ICU, and the unexpected occurrence of major perioperative and postoperative complications. The actual impact of unplanned admission to ICU after surgery on clinical outcome remains uncertain, given the conflicting results from several observational studies and recent randomized clinical trials. Nonetheless, unplanned ICU admission after surgery results a significant strain on hospital resources. Consequently, this issue should be addressed in hospital policy with the aim of implementing preoperative risk assessment and patient evaluation, effective communication, vigilant supervision, and the promotion of cooperative healthcare.

Summary: Unplanned ICU admission after surgery is a multifactorial phenomenon that imposes a significant burden on healthcare systems without a clear impact on clinical outcome. Thus, the early identification of patient necessitating ICU interventions is imperative.

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来源期刊
CiteScore
4.90
自引率
8.00%
发文量
207
审稿时长
12 months
期刊介绍: ​​​​​​​​Published bimonthly and offering a unique and wide ranging perspective on the key developments in the field, each issue of Current Opinion in Anesthesiology features hand-picked review articles from our team of expert editors. With fifteen disciplines published across the year – including cardiovascular anesthesiology, neuroanesthesia and pain medicine – every issue also contains annotated references detailing the merits of the most important papers.
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