高流氧疗法与面罩预氧化在预期的困难的呼吸道管理 (PREOPTI-DAM):一个开放标签,单中心,随机控制的第三阶段试验
Mickael Vourc'h1,2, Donatien Huard2,3, Marguerite Le Penndu2,3
1Service d'Anesthésie Réanimation Chirurgie Cardiaque, Hôpital Laennec, CHU de Nantes, France.
EClinicalMedicine
|May 30, 2023
概括
与面罩相比,通过鼻 (HFNC) 的高流量疗法在困难的气道输管过程中并没有显著降低脱度. 然而,HFNC在这个关键的过程中提高了患者的满意度.
科学领域:
- 麻醉学 麻醉学
- 关键护理医学 关键护理医学
- 呼吸系统疗法 呼吸系统疗法
背景情况:
- 难以管理的气道存在重大风险,建议通过鼻腔管 (HFNC) 进行高流量治疗,以进行氧化前.
- 现有的证据不足以充分支持HFNC在这种情况下的建议.
研究的目的:
- 评估HFNC与传统面罩在预期难以管理呼吸道的患者中进行氧化前的疗效.
- 为了评估氧气脱的主要结果或在输管过程中需要袋口罩通风.
主要方法:
- 一个第三阶段,单中心,开放标签,随机对照试验 (PREOPTI-DAM) 涉及185名患者.
- 患者通过HFNC或面罩获得4分钟的先氧化,按输管策略分层.
- 主要结果:氧气和率≤94%或口罩通风的发生率.
主要成果:
- 在HFNC (2%) 和面罩 (8%) 组之间的初级结果没有显著差异 (P=0.10).
- 在HFNC组报告的良好或优秀的输管体验率显着更高 (80%对59%,P=0.016).
- 两组之间严重和中度并发症的发病率相似;没有死亡或心脏骤停.
结论:
- 在预期的困难的气道输管过程中,HFNC并没有显著减少脱事件,但试验的功率不足.
- 与面罩前氧化相比,HFNC证明了患者满意度的提高.
- 需要进一步的研究来证实HFNC在困难的气道管理中的潜在益处和最佳使用.
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