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机械呼吸机断奶方案对婴儿和儿童呼吸结果的影响:一项随机对照试验
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
概括
儿童呼吸机断奶方案并没有显著缩短儿童输管的时间. 标准护理与压力支通风 (PSV) 或体积支通风 (VSV) 协议一样有效,用于儿科机械通风断奶.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 呼吸系统疗法 呼吸系统疗法
背景情况:
- 风机管理协议被证明可以加速成年人的断奶.
- 这些方案在儿科患者群体中的有效性仍未得到充分研究.
研究的目的:
- 为了比较断奶协议与儿童机械通风中的标准护理.
- 评估体积支通风 (VSV) 是否优于压力支通风 (PSV) 在断奶时.
主要方法:
- 一项在10个北美儿科重症监护病房进行的随机对照试验.
- 182名儿童 (<18岁) 接受机械通风超过24小时被随机分类.
- 组包括PSV协议,VSV协议和没有协议.
主要成果:
- 在PSV (15%),VSV (24%) 和无协议 (17%) 组之间,输出失败率没有显著差异.
- 各组中断奶的平均持续时间相似:PSV (1.6天),VSV (1.8天),没有协议 (2.0天).
- 男性性别和增加的镇静剂使用预测了输出失败和延长的断奶时间.
结论:
- 大多数儿童在2天内从机械通风中断奶.
- 在这个儿科队列中,断奶协议并没有显著减少断奶时间.
- 这些发现与成年人研究相反,表明儿童的断奶动态不同.
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