非侵袭性正压通风用于术后呼吸困扰:一项随机对照试验
Sean P Keenan1, Caroline Powers, David G McCormack
1Department of Medicine, Royal Columbian Hospital, New Westminster, British Columbia, Canada. Sean_Keenan@telus.net
JAMA
|June 22, 2002
概括
非侵入性正压通风 (NPPV) 并没有降低高风险患者的再输管率,这些患者在输管术后经历呼吸困扰. 这项研究发现,与单独使用标准医学治疗相比,结果没有显著差异.
科学领域:
- 关键护理医学 关键护理医学
- 呼吸系统医学 呼吸系统医学
- 肺部疾病 肺部疾病
背景情况:
- 非侵入性正压通风 (NPPV) 是有效的急性呼吸衰竭.
- 它在输出管后呼吸困扰患者中的使用缺乏随机对照试验证据.
研究的目的:
- 评估NPPV有效性与标准疗法对高风险患者预防重新输管.
- 在输出管后48小时内专注于呼吸困扰.
主要方法:
- 随机,受控,非盲目的试验与隐藏的分配.
- 81 患有心脏/呼吸系统疾病或长时间通风的高风险患者.
- 干预措施:标准治疗与NPPV加标准治疗.
主要成果:
- 在再灌输率上没有显著差异 (72%对69%).
- 医院死亡率没有差异 (两组均为31%).
- 机械通风,ICU和住院时间的持续时间相似.
结论:
- 将NPPV添加到标准疗法并没有改善异质患者的治疗结果,这些患者患有输出管后呼吸困扰.
- 在这个特定的高风险人群中,NPPV并不优于标准护理.
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