COVID-19的驱动力:它如何塑造了非侵入性呼吸支持的证据
Yorschua Jalil1,2,3,4, Martina Ferioli1,2,5,6, Martin Dres1,2
1INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Sorbonne Université, 75006 Paris, France.
Journal of clinical medicine
|May 27, 2023
概括
在COVID-19患者的急性缺血性呼吸衰竭中,非侵入性呼吸支持 (NIRS) 是至关重要的. 本综述综合了NIRS方法的证据,如高流量鼻氧和CPAP,指导最佳的临床使用.
科学领域:
- 临界护理医学 临界护理医学
- 肺部病理学 肺部病理学
- 传染性疾病 传染性疾病
背景情况:
- 随着COVID-19的流行,急性低血量呼吸衰竭的非侵入性呼吸支持 (NIRS) 的使用显著增加.
- NIRS提供了输管替代方案,减轻了风险,并解决了ICU容量问题.
- 广泛的研究出现了,包括观察性研究,临床试验,评论和元分析.
研究的目的:
- 为COVID-19患者提供NIRS的全面叙事概述.
- 检查NIRS的生理学理由,流行前的证据和最近的研究结果.
- 突出目前的指导方针,并确定未来研究的领域.
主要方法:
- 对COVID-19中NIRS的观察性研究和随机对照试验的文献综述.
- 专注于高流量鼻氧 (HFNO),非侵入性机械通风 (NIMV) 和持续正气道压力 (CPAP).
- 关于COVID-19和急性缺血性呼吸衰竭的成年患者数据的综合.
主要成果:
- 在COVID-19中,包括HFNO,NIMV和CPAP在内的NIRS已被广泛研究.
- 来自观察性研究和RCT的证据为NIRS应用提供了信息.
- 国际指南为NIRS使用提供了建议.
结论:
- 在管理COVID-19相关的急性缺血性呼吸衰竭方面,NIRS发挥着至关重要的作用.
- 需要进一步的精心设计的研究来优化NIRS策略.
- 证据综合支持关于NIRS的知情临床决策.
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