[1]诸葛炜,许莉莉,孟盈彤,等.重症监护病房儿童氧合状态与谵妄发作的相关性研究[J].军事护理,2023,40(04):15-18.[doi:10.3969/j.issn.2097-1826.2023.04.004]
 ZHUGE Wei,XU Lili,MENG Yingtong,et al.Correlation Between Oxygenation State and Delirium Among Pediatric Patients in Intensive Care Unit[J].Nursing Journal Of Chinese People's Laberation Army,2023,40(04):15-18.[doi:10.3969/j.issn.2097-1826.2023.04.004]
点击复制

重症监护病房儿童氧合状态与谵妄发作的相关性研究
分享到:

《军事护理》[ISSN:2097-1826/CN:31-3186/R]

卷:
40
期数:
2023年04期
页码:
15-18
栏目:
儿童护理专栏
出版日期:
2023-04-15

文章信息/Info

Title:
Correlation Between Oxygenation State and Delirium Among Pediatric Patients in Intensive Care Unit
文章编号:
2097-1826(2023)04-0015-04
作者:
诸葛炜1许莉莉2孟盈彤3戈晓华3
(1.上海交通大学 护理学院,上海 200025; 2.上海交通大学医学院附属新华医院 小儿危重症医学科,上海 200092; 3.上海交通大学医学院附属新华医院 护理部)
Author(s):
ZHUGE Wei1XU Lili2MENG Yingtong3GE Xiaohua3
(1.School of Nursing,Shanghai Jiao Tong University,Shanghai 200025,China; 2.Pediatric Emergency and Critical Care Department,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China 3.Nursing Department,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine)
关键词:
谵妄 重症监护病房 氧合状态 儿童
Keywords:
delirium intensive care unit oxygenation state children
分类号:
R473.72
DOI:
10.3969/j.issn.2097-1826.2023.04.004
文献标志码:
A
摘要:
目的 探讨重症监护病房(intensive care unit,ICU)儿童氧合状态与谵妄发作之间的关系。方法 2021年10月至2022年3月,方便抽样法选取某三级甲等医院289例ICU儿童为研究对象,收集患儿氧合状态等相关临床资料,采用躁动镇静量表和康奈尔儿童谵妄评估量表对其进行调查。结果 ICU儿童谵妄发生率为34.3%。Spearman相关分析显示,氧合状态与谵妄发作呈负相关(P<0.001)。Logistic回归分析结果显示:年龄、胎龄、感染、肾功能异常、镇静药物及氧合状态受损是ICU儿童谵妄发作的主要影响因素(均P<0.05); 氧合状态受损严重程度每增加一个等级,谵妄发作风险增加2.47倍(P<0.001)。结论 ICU儿童氧合状态越差,越容易发生谵妄。医护人员应加强对患儿氧合状态的监测并及时采取针对性干预措施,积极纠正氧合状态受损,从而降低谵妄发生率。
Abstract:
Objective To investigate the correlation between oxygenation state and delirium among pediatric patients in Intensive Care Unit(ICU).Methods The convenience sampling method was used to select 289 pediatric patients in ICU in a tertiary A hospital from October 2021 to March 2022.Oxygenation state and other clinical data were collected.Richmond agitation-sedation scale(RASS)and Cornell assessment of pediatric delirium scale(CAPD)were used for investigation.Results Among the 289 subjects,the incidence of delirium was 34.3%.Spearman correlation analysis showed that oxygenation state was negatively correlated with delirium onset(P<0.001).Logistic regression analysis showed that age,gestational,infection,renal dysfunction,sedation and impaired oxygenation state were the main influencing factors of delirium(all P<0.05)The risk of delirium increased by 2.47 times for each increased grade of severity of impaired oxygenation(P<0.001).Conclusions The worse the oxygenation state of pediatric patients in ICU,the more likely the delirium occurs.Nurses should strengthen the monitoring of oxygenation state and take timely targeted intervention measures to actively correct the impairment of oxygenation state,so as to reduce the incidence of delirium.

参考文献/References:

[1] ROSE L,BURRY L,AGAR M,et al.A core outcome set for research evaluating interventions to prevent and/or treat delirium in critically ill adults:an international consensus study(Del-COrS)[J].Crit Care Med,2021,49(9):1535-1546.
[2] GE X H,WEI W R,FENG T N,et al.Analysis of risk factor for pediatric intensive care unit delirium in children:a case-control study [J].Am J Transl Res,2021,13(8):9143-9151.
[3] DEVLIN J W,SKROBIK Y,GELINAS C,et al.Clinical practice guidelines for the prevention and management of pain,agitation/sedation,delirium,immobility,and sleep disruption in adult patients in the ICU [J].Crit Care Med,2018,46(9):e825-e873.
[4] GIRARD T D,THOMPSON J L,PANDHARIPANDE P P,et al.Clinical phenotypes of delirium during critical illness and severity of subsequent long-term cognitive impairment: a prospective cohort study [J].Lancet Respir Med,2018,6(3):213-222.
[5] RANIERI V M,RUBENFELD G D,THOMPSON B T,et al.Acute respiratory distress syndrome:the Berlin definition [J].JAMA,2012,307(23):2526-2533.
[6] ELY E W,TRUMAN B,SHINTANI A,et al.Monitoring sedation status over time in ICU patients:reliability and validity of the Richmond agitation-sedation scale(RASS)[J].JAMA,2003,289(22):2983-2991.
[7] 何珊,王亚力,左泽兰.中文版康奈尔儿童谵妄量表的临床初步应用 [J].中华儿科杂志,2019,57(5):344-349.
[8] RAHMAN A E,HOSSAIN A T,NAIR H,et al.Prevalence of hypoxaemia in children with pneumonia in low-income and middle-income countries:a systematic review and meta-analysis [J].Lancet Glob Health,2022,10(3):e348-e359.
[9] SRLF Trial Group.Hypoxemia in the ICU: prevalence,treatment,and outcome[J/OL].[2022-06-30].https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6089859/.DOI:10.1186/s13613-018-0424-4.
[10]ENGEL G L,ROMANO J.Delirium,a syndrome of cerebral insufficiency.1959[J].J Neuropsychiatry Clin Neurosci,2004,16(4):526-538.
[11]刘柯显,徐红贞.小儿术后谵妄影响因素的研究进展[J].解放军护理杂志,2020,37(10):61-4.
[12]TRAUBE C,SILVER G,GERBER L M,et al.Delirium and mortality in critically ill children:epidemiology and outcomes of pediatric delirium[J].Crit Care Med,2017,45(5):891-898.
[13]MODY K,KAUR S,MAUER E A,et al.Benzodiazepines and development of delirium in critically ill children:estimating the causal effect[J].Crit Care Med,2018,46(9):1486-1491.
[14]徐婷婷,张伟英,周如女.儿童谵妄早期识别及护理干预的研究进展[J].中华护理杂志,2020,55(8):1170-1174.
[15]SILVER G,TRAUBE C,GERBER L M,et al.Pediatric delirium and associated risk factors:a single-center prospective observational study[J].Pediatr Crit Care Med,2015,16(4):303-309.
[16]POTHARAJAROEN S,TANGWONGCHAI S,TAYJASANANT T,et al.Bright light and oxygen therapies decrease delirium risk in critically ill surgical patients by targeting sleep and acid-base disturbances[J].Psychiatry Res,2018(261):21-27.

相似文献/References:

[1]杨玉霞,顾莺,胡静,等.儿科重症监护病房患儿肠内营养中断的研究进展[J].军事护理,2021,38(02):69.[doi:10.3969/j.issn.1008-9993.2021.02.018]
[2]邵小平,唐雯琦,胡三莲.集束化方案对降低危重症患者肠内营养相关误吸的效果研究[J].军事护理,2021,38(05):5.[doi:10.3969/j.issn.1008-9993.2021.05.002]
 SHAO Xiaoping,TANG Wenqi,HU Sanlian.Effect of Care Bundles on Reducing Enteral Nutrition-Related Aspiration in Critically Ill Patients[J].Nursing Journal Of Chinese People's Laberation Army,2021,38(04):5.[doi:10.3969/j.issn.1008-9993.2021.05.002]
[3]刘宏见,牟绍玉,罗静,等.基于临床护理分类系统的重症监护室电子护理记录系统的开发与应用[J].军事护理,2021,38(08):85.[doi:10.3969/j.issn.1008-9993.2021.08.023]
 LIU Hongjian,MOU Shaoyu,LUO Jing,et al.Development and Application of Electronic Nursing Recording System of Intensive Care Units Based on the Clinical Care Classification System[J].Nursing Journal Of Chinese People's Laberation Army,2021,38(04):85.[doi:10.3969/j.issn.1008-9993.2021.08.023]
[4]史广玲,徐建珍,刘夕珍,等.重症监护病房患者大便失禁相关性皮炎预测风险模型的建立和验证[J].军事护理,2021,38(11):37.[doi:10.3969/j.issn.1008-9993.2021.11.010]
 SHI Guangling,XU Jianzhen,LIU Xizhen,et al.Development and Validation of A Predictive Risk Model for Fecal Incontinence Associated Dermatitis in ICU Patients[J].Nursing Journal Of Chinese People's Laberation Army,2021,38(04):37.[doi:10.3969/j.issn.1008-9993.2021.11.010]
[5]王汇,程岚,唐淑慧,等.失效模式与效应分析在降低ICU患者肠内营养相关性腹泻中的应用[J].军事护理,2022,39(09):25.[doi:10.3969/j.issn.1008-9993.2022.09.007]
 WANG Hui,CHENG Lan,TANG Shuhui,et al.Application of Failure Mode and Effect Analysis in Reducing Enteral Nutrition-Related Diarrhea in ICU Patients[J].Nursing Journal Of Chinese People's Laberation Army,2022,39(04):25.[doi:10.3969/j.issn.1008-9993.2022.09.007]
[6]祁聪慧,康凤英,赵文芳,等.ICU急性肾损伤患者连续性肾脏替代治疗上机时家属决策困境的现象学研究[J].军事护理,2023,40(03):41.[doi:10.3969/j.issn.2097-1826.2023.03.010]
 QI Conghui,KANG Fengying,ZHAO Wenfang,et al.Family Decision-making Dilemma of Continuous Renal Replacement Therapy for Patients with Acute Kidney Injury in ICU:A Phenomenological Study[J].Nursing Journal Of Chinese People's Laberation Army,2023,40(04):41.[doi:10.3969/j.issn.2097-1826.2023.03.010]
[7]李丝静,江智霞,谢光辉,等.虚拟现实系统在重症患者中应用的范围综述[J].军事护理,2023,40(08):35.[doi:10.3969/j.issn.2097-1826.2023.08.009]
 LI Sijing,JIANG Zhixia,XIE Guanghui,et al.Application of Virtual Reality System in Critically Ill Patients: A Scoping Review[J].Nursing Journal Of Chinese People's Laberation Army,2023,40(04):35.[doi:10.3969/j.issn.2097-1826.2023.08.009]

备注/Memo

备注/Memo:
【 收稿日期 】 2022-08-25 【 修回日期 】 2022-12-27
【 基金项目 】 上海市科委基金项目资助(21511100502)
【 作者简介 】 诸葛炜,硕士在读,电话:021-25076124
【 通信作者 】 戈晓华,电话:021-25076124
更新日期/Last Update: 2023-04-15