在重症监护病房的高流氧疗法和其他吸入疗法
Sean D Levy1, Jehan W Alladina1, Kathryn A Hibbert1
1Division of Pulmonary, Critical Care, and Sleep Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
高流量鼻腔管有利于选择的呼吸衰竭患者. 其他吸入疗法对喘和肺高血压等特定疾病有希望,但不建议在ARDS中常规使用.
科学领域:
- 临界护理医学 临界护理医学
- 呼吸系统疗法 呼吸系统疗法
- 肺部医学 肺部医学
背景情况:
- 危急病患者通常需要先进的呼吸辅助.
- 在重症监护中吸入疗法的证据正在发展.
- 优化氧化和通风对于患者的治疗结果至关重要.
研究的目的:
- 对重症患者的高流氧,吸入气体和气溶的现有证据进行审查.
- 评估这些疗法的疗效和适用情况.
- 为它们在临床实践中的适当使用提供指导.
主要方法:
- 对现有文献进行系统审查.
- 分析临床试验数据和专家共识.
- 对特定的吸入剂和设备的证据的评估.
主要成果:
- 高流量鼻腔管在急性缺血性呼吸衰竭中得到支持.
- 赫里奥克斯可能有助于避免输管和气体流动在严重的喘和阻塞性肺病.
- 吸入的氧化和前列腺素对ARDS的益处有限,但可能有助于特定的肺高血压病例.
- 喷雾式支气管扩展剂在喘/COPD中有用,但不是ARDS.
- 喷雾式抗生素显示出对VAP/VAP的潜力,具有可变的输送.
结论:
- 高流量鼻腔管为选择的呼吸衰竭患者提供了好处.
- 吸入疗法在重症监护中具有具体的,基于证据的应用.
- 对于喷雾剂药物来说,必须仔细考虑输送方法.
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