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ARDS hos intensivvårdspatienter som har genomgått bäckenfrakturkirurgi: En retrospektiv journalgranskningsstudie
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
2012 (Swedish)Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
Abstract [sv]

Syfte: Att undersöka förekomst av ARDS hos intensivvårdspatienter som har genomgått bäckenfrakturkirurgi, identifiera skillnader mellan gruppen som utvecklar ARDS och gruppen som inte gör det samt undersöka i hur stor uträckning olika faktorer påverkade uppkomsten av ARDS.

Metod: Studien var en retrospektiv journalgranskningsstudie. 61 patienter inkluderades i studien. Förekomst av ARDS klassificerades utifrån Ranieris definition gällande PaO2/FiO2-kvot och PEEP-nivå, röntgenbild har frånsetts i den här studien. Data analyserades genom oberoende t-test, Mann Whitney U test och univariat logistisk regressionsanalys.

Resultat: ARDS förekom hos 47 (77 %), av de 61 patienter som ingick i studien, någon gång under vårdtiden. Operationsdygnet var det dygn ARDS sågs hos flest patienter under samma dygn, 38 (62 %) patienter uppvisade då ARDS. Lång väntetid till operation och flertalet dygn i ventilator identifierades som prediktorer för uppkomst av ARDS. Mängd transfusion av kolloider återfanns vara signifikant större hos gruppen som utvecklade ARDS och var även det en prediktor för utveckling av ARDS.

Slutsats: Resultatet visade att patienter med bäckenfraktur är en högriskgrupp för utveckling av ARDS. Lång väntetid till operation, flertalet dygn i ventilator preoperativt och massiv transfusion av kolloider identifierades som faktorer som medför en ökad risk för att patienten ska utveckla ARDS.

Abstract [en]

Aim: To explore ARDS in patients in the intensive care unit with a pelvic fracture requiring surgical treatment, find differences between those who have ARDS and those who don’t, and to explore how different factors affect the development of ARDS.

Method: The study was a retrospective journal review. A total number of 61 patients were included in the study. ARDS was defined by Ranieri’s criterias according to PaO2/FiO2-ratio and PEEP, X-ray was not included in this study. The analyses used in the study were Independent t-test, Mann-Whitney U test and univariate logistic regression analysis.

Result: The result shows that 47 (77%) of the 61 patients included in the study had ARDS at least one day during the days of treatment. During the day of surgery the maximum number of patients with ARDS were identified on the same day, 38 (62 %) of the patients had ARDS that day. Long wait for surgery was one identified predictor. Several days in ventilator and massive transfusion of colloids before surgery were affecting the development of ARDS. 

Conclusion: Patients having a pelvic fractures requiring surgical treatment are at a high risk of developing ARDS. Long wait for surgery, several days in ventilator and massive transfusion of colloids were correlating with ARDS.

Place, publisher, year, edition, pages
2012. , 40 p.
Keyword [en]
Pelvis, Acetabulum, Fractures, ARDS, intensive care
Keyword [sv]
Bäcken, Acetabulum, Frakturer, ARDS, intensivvård
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-175693OAI: oai:DiVA.org:uu-175693DiVA: diva2:532541
Subject / course
Caring Sciences
Educational program
Specialistsjuksköterskeprogrammet med inriktning mot intensivvård
Uppsok
Medicine
Supervisors
Examiners
Available from: 2012-06-29 Created: 2012-06-11 Last updated: 2012-06-29Bibliographically approved

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