在低风险患者中,高流量鼻腔管与常规氧气治疗对再输入管的影响:随机临床试验
Gonzalo Hernández1, Concepción Vaquero2, Paloma González3
1Hospital Virgen de la Salud, Toledo, Spain.
JAMA
|March 16, 2016
概括
与传统氧气疗法相比,高流量鼻氧疗法显著降低了急性病患者的再灌输率. 这种干预措施还降低了呼吸衰竭的发病率,改善了患者的治疗结果.
科学领域:
- 危急护理医学
- 呼吸疗法
- 肺病学
背景情况:
- 高流量鼻腔 (HFNC) 氧疗法在输出管后改善氧化方面显示出前景.
- 之前的研究结合高风险和低风险人群表明HFNC的好处.
- 对于特定的低风险患者的再灌输率缺乏确的数据.
研究的目的:
- 评估HFNC氧疗法在机械通风患者中预防再输液的有效性.
- 在这一组患者中,将HFNC氧疗法与常规氧疗法进行比较.
主要方法:
- 这是一项多中心随机临床试验,涉及527名西班牙7个急症室的低风险成人患者.
- 患者被随机分为接受HFNC氧疗法或常规氧疗法24小时.
- 主要结局是72小时内重新灌输;次要结局包括呼吸衰竭,感染,停留时间和死亡率.
主要成果:
- 与常规氧气组 (12. 2%) 相比,HFNC组在72小时内重新输液的发生频率较低 (P=. 004).
- 在HFNC组中,呼吸衰竭也显著降低 (8. 3%对14. 4%,P=. 03).
- 没有观察到重灌时间的显著差异,也没有报告任何不良事件.
结论:
- 在低风险的脱管患者中,HFNC氧疗优于常规氧疗,可降低72小时内再输管的风险.
- 这些发现支持使用HFNC氧疗法作为选择的低风险术后患者的标准护理.
- HFNC治疗提供了一种安全有效的策略来预防早期的再输液和呼吸道并发症.
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