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機械呼吸器の断乳プロトコルの乳幼児と子供の呼吸器への影響:ランダム化制御試験
Adrienne G Randolph1, David Wypij, Shekhar T Venkataraman
1Children's Hospital, MICU, FA-108, 300 Longwood Ave, Boston, MA 02115, USA. adrienne.randolph@tch.harvard.edu
JAMA
|November 28, 2002
まとめ
小児の呼吸器離乳プロトコルは,小児のエクストゥベーションの時間を大幅に短縮しなかった. 標準的な介護は,小児の機械換気断絶のための圧力サポート換気 (PSV) または体積サポート換気 (VSV) プロトコルと同じくらい効果的です.
科学分野:
- 小児重症治療薬は,小児重症治療薬として使用されています.
- 呼吸器療法とは
背景:
- 呼吸器管理プロトコルは,成人の離乳を早めるのに効果があることが証明されています.
- 小児の集団におけるこれらのプロトコルの有効性は,まだ十分に研究されていない.
研究 の 目的:
- 離乳プロトコルと小児の機械換気における標準的なケアを比較する.
- 断乳時の容量サポート換気 (VSV) が圧力サポート換気 (PSV) よりも優れているかどうかを評価する.
主な方法:
- 北米の10の小児重症病棟におけるランダム化制御試験である.
- 機械呼吸器を24時間以上受けた182人の子供 (<18歳) がランダムに randomized されました.
- グループには,PSVプロトコル,VSVプロトコル,およびプロトコルなしが含まれていました.
主要な成果:
- PSV (15%),VSV (24%) とプロトコルなし (17%) のグループでは,エクスチューベーション失敗率に有意な差異はありませんでした.
- 離乳期間の中央値は,PSV (1.6日),VSV (1.8日),プロトコルなし (2.0日) のグループ間で類似していました.
- 男性の性別と鎮静剤の使用量の増加は,エクストゥベーションの失敗と離乳期間延長を予測しました.
結論:
- ほとんどの子供は2日以内に機械呼吸器から離乳されます.
- 離乳プロトコルは,この小児科コホートで離乳期間を有意に短縮しませんでした.
- 発見は成人の研究と対照的であり,子供の離乳のダイナミクスが異なることを示唆しています.
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