由护士主导每日唤醒在重症机械通气患者中的应用

目的观察由护士主导执行的每日唤醒在重症机械通气患者镇痛镇静治疗中的可行性和临床效果。方法选择2013年1—12月ICU收治的机械通气患者120例,随机分为对照组和观察组各60例,对照组由护士主导执行每日唤醒,观察组由管床医师依据患者病情决定唤醒时机,护士具体执行。观察两组镇静剂用量、停药后完全清醒时间、机械通气时间、总镇静时间、ICU住院时间及不良事件发生情况。结果观察组患者咪达唑仑用量、停药后完全清醒时间、机械通气时间、总镇静时间以及ICU住院时间比较,观察组均优于对照组,差异有统计学意义(P0.05);两组间情绪、心率、血压异常比较差异均无统计学意义(P0.05),两组患者均无非计划拔管发生。结论由护士主导执行的每日唤醒在重症机械通气患者镇痛镇静治疗中效果显著,值得临床推广应用。

Effect of Daily Sedation Interruption Performed by Nurses on Mechanically Ventilated Critically Ill Patients

Objective To observe the feasibility and clinical effect of daily sedation interruption（DSI） performed by nurses on critically ill patients with mechanical ventilation. Methods A total of 120 patients were randomly divided into experiment group, in which daily sedation interruption performed by nurses was provided and control group, in which traditional sedation treatment was provided. Duration of mechanical ventilation, sedative dosage, length of stay in ICU, incidence rate of adverse reaction were compared in both groups. Results There＇s no unplanned extubation in both groups. The duration of mechanical ventilation, sedative dosage and ICU length of stay decreased in experiment group, which was of statistical significance（P0.05）but intergroup comparison found no statistical significance in patients＇ emotion, heart rate and blood pressure（P0.05）. Conclusion The daily sedation interruption performed by nurses is feasible and effective for critically ill patients with mechanical ventilation.