高流量温湿氧与适度支气管炎的标准低流量鼻腔氧 (HFWHO RCT):一个开放的,第四阶段的随机对照试验
Elizabeth Kepreotes1, Bruce Whitehead2, John Attia3
1John Hunter Children's Hospital, Newcastle, NSW, Australia; Priority Research Centre GrowUpWell, University of Newcastle, Newcastle, NSW, Australia; Faculty of Health, University of Newcastle, Newcastle, NSW, Australia; Hunter Medical Research Institute, Newcastle, NSW, Australia.
高流热加湿氧 (HFWHO) 没有缩短中度支气管炎的婴儿的氧气断奶时间. 然而,HFWHO可以作为一种救援疗法,以减少重症监护室的入院.
科学领域:
- 儿童医学
- 呼吸系统医学
- 临床试验
背景情况:
- 支气管炎是一种常见的婴儿肺部感染,需要呼吸辅助.
- 高流热加湿氧 (HFWHO) 越来越多地使用,但缺乏可靠的试验数据.
- 目前的治疗重点是控制呼吸困难和缺氧.
研究的目的:
- 评估HFWHO是否会缩短中度支气管炎的婴儿的断奶时间.
- 与标准氧气治疗相比,评估HFWHO的安全性和有效性.
- 确定HFWHO在减少重症监护室 (ICU) 转移方面的潜在作用.
主要方法:
- 这是一项开放的4期随机对照试验,涉及202名中度支气管炎的24个月以下的儿童.
- 参与者被随机分为1:1接受HFWHO或标准氧气治疗.
- 主要结果是氧气治疗的最后一次使用时间;安全性和治疗失败也被评估.
主要成果:
- HFWHO没有显著减少氧气断奶的中位时间 (20小时与24小时; p=0. 61).
- 治疗失败率显著低于HFWHO (14%对33%;p=0. 0016).
- 在不同组的ICU转移率相似 (14%的HFWHO与12%的标准;p=0. 41),在61%的标准治疗失败中使用HFWHO进行救援.
结论:
- 在中度支气管炎中,HFWHO没有缩短氧气持续时间,这表明它不会改变疾病的进程.
- HFWHO显示出作为救援疗法的潜力,减少了对重症监护的需求.
- 这项研究证实了HFWHO在该患者群体中的安全性.
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