Eur Respir J:危重细支气管炎患儿的疾病负担及临床实践变化!

2017-06-18 xing.T MedSci原创

研究人员观察到由于严重的细支气管炎引起的医疗负担日益加重,临床实践中的主要变化从侵入性到非侵入性支持提示细支气管炎患者进入ICU的阈值已经改变。未来的研究应评估在ICUs外细支气管炎的治疗策略。

细支气管炎是非选择性入住儿科重症监护病房(ICU)最常见的原因。近日,呼吸疾病领域权威杂志Eur Respir J上发表了一篇研究文章,研究人员旨在评估2002年和2014年期间澳大利亚和新西兰<24个月的入住ICU的细支气管炎婴儿入院率、呼吸支持和结局的变化。

在研究期间,在34 829名非选择入住ICU的患儿中有9628名(27.6%)细支气管炎患儿。估计的以人群为基础的ICU入院率由于细支气管炎增加至11.76人每100000人 每年(95%可信区间为8.11-15.41)。需要气管插管的细支气管炎患者的比例从2002年的36.8%降低至2014年的10.8%(调整后的比值比为0.35,95%可信区间为0.27-0.46),而高流量鼻套管治疗使用率增加到72.6%(p<0.001)。

研究人员观察到不同ICU间的实践有相当大的差异,在风险调整的插管率上存在六倍的差异,而不能由ICU类型、大小或主要病人因素来进行解释。每年的直接医疗费用由于严重的支气管炎增加到2014年的3000万美元。

研究人员观察到由于严重的细支气管炎引起的医疗负担日益加重,临床实践中的主要变化从侵入性到非侵入性支持提示细支气管炎患者进入ICU的阈值已经改变。未来的研究应评估在ICUs外细支气管炎的治疗策略。

原始出处:

Luregn J. Schlapbach,et al. Burden of disease and change in practice in critically ill infants with bronchiolitis. Eur Respir J. http://erj.ersjournals.com/content/49/6/1601648

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time=2017-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=212654, encodeId=64c32126547f, content=评估在ICUs外细支气管炎的治疗策略。, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3wrgsNyr5lh6N2MY5xSnbvo4g5sRlc3MZoDdWpMeSdozUCPNhA96wndwQe3X5Z5oYMNxVUdOib63nw/0, createdBy=d8d11998754, createdName=Julie W, createdTime=Mon Jun 19 08:18:42 CST 2017, time=2017-06-19, status=1, ipAttribution=)]
    2017-06-19 惠映实验室

    学习了,谢谢分享。

    0

  7. 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encodeId=4c612126e59c, content=学习了。。。。。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/icyLhIGqru6gIknBJqfuPhYUE4da7HxQiaMRRk8Ix0r6sfdeeibLPNib7H5IoNf4kYsecwUsmQC1eUMKsNb65twN7epPZaicdLRCu/0, createdBy=ba1a1999418, createdName=Norene, createdTime=Mon Jun 19 09:43:41 CST 2017, time=2017-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=212672, encodeId=62e72126e234, content=危重细支气管炎患儿的疾病负担变化, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLBkyaelI9ia3n9SbuKmBdaY0PqCOzd0nhRUstroXmUmXZ5EBTmibtLEvCCIpyHAqxQXGfZz49ibrwjkg/0, createdBy=39781652829, createdName=雾夜芭蕾, createdTime=Mon Jun 19 09:16:28 CST 2017, time=2017-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=212654, encodeId=64c32126547f, content=评估在ICUs外细支气管炎的治疗策略。, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3wrgsNyr5lh6N2MY5xSnbvo4g5sRlc3MZoDdWpMeSdozUCPNhA96wndwQe3X5Z5oYMNxVUdOib63nw/0, createdBy=d8d11998754, createdName=Julie W, createdTime=Mon Jun 19 08:18:42 CST 2017, time=2017-06-19, status=1, ipAttribution=)]
    2017-06-19

    <24个月的婴幼儿!

    0

  8. 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encodeId=4c612126e59c, content=学习了。。。。。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/icyLhIGqru6gIknBJqfuPhYUE4da7HxQiaMRRk8Ix0r6sfdeeibLPNib7H5IoNf4kYsecwUsmQC1eUMKsNb65twN7epPZaicdLRCu/0, createdBy=ba1a1999418, createdName=Norene, createdTime=Mon Jun 19 09:43:41 CST 2017, time=2017-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=212672, encodeId=62e72126e234, content=危重细支气管炎患儿的疾病负担变化, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLBkyaelI9ia3n9SbuKmBdaY0PqCOzd0nhRUstroXmUmXZ5EBTmibtLEvCCIpyHAqxQXGfZz49ibrwjkg/0, createdBy=39781652829, createdName=雾夜芭蕾, createdTime=Mon Jun 19 09:16:28 CST 2017, time=2017-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=212654, encodeId=64c32126547f, content=评估在ICUs外细支气管炎的治疗策略。, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3wrgsNyr5lh6N2MY5xSnbvo4g5sRlc3MZoDdWpMeSdozUCPNhA96wndwQe3X5Z5oYMNxVUdOib63nw/0, createdBy=d8d11998754, createdName=Julie W, createdTime=Mon Jun 19 08:18:42 CST 2017, time=2017-06-19, status=1, ipAttribution=)]
    2017-06-19 Norene

    学习了。。。。。。

    0

  9. 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time=2017-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=212654, encodeId=64c32126547f, content=评估在ICUs外细支气管炎的治疗策略。, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3wrgsNyr5lh6N2MY5xSnbvo4g5sRlc3MZoDdWpMeSdozUCPNhA96wndwQe3X5Z5oYMNxVUdOib63nw/0, createdBy=d8d11998754, createdName=Julie W, createdTime=Mon Jun 19 08:18:42 CST 2017, time=2017-06-19, status=1, ipAttribution=)]
    2017-06-19 雾夜芭蕾

    危重细支气管炎患儿的疾病负担变化

    0

  10. 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time=2017-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=212654, encodeId=64c32126547f, content=评估在ICUs外细支气管炎的治疗策略。, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3wrgsNyr5lh6N2MY5xSnbvo4g5sRlc3MZoDdWpMeSdozUCPNhA96wndwQe3X5Z5oYMNxVUdOib63nw/0, createdBy=d8d11998754, createdName=Julie W, createdTime=Mon Jun 19 08:18:42 CST 2017, time=2017-06-19, status=1, ipAttribution=)]
    2017-06-19 Julie W

    评估在ICUs外细支气管炎的治疗策略。

    0

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