通过使用层次聚类分析对患有支气管肺功能失调的婴儿进行侵入性机械通风的多中心方法进行分类
Matthew J Kielt1, L Dupree Hatch2, Jonathan C Levin3
1Division of Neonatology, Department of Pediatrics, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, Ohio, USA.
Pediatric pulmonology
|June 2, 2023
概括
分析了患有严重支气管肺功能障碍 (BPD) 的婴儿的呼吸器设置,揭示了三个不同的通风策略. 需要进一步的研究来将这些策略与临床结果联系起来.
科学领域:
- 新生儿医学 新生儿医学
- 儿科呼吸系统医学 儿科呼吸系统医学
- 关键护理医学 关键护理医学
背景情况:
- 针对严重支气管肺功能障碍 (BPD) 的基于证据的通风策略尚不清楚.
- 当代的通风方法可能代表着不同的BPD护理策略.
- 描述这些策略可以改善BPD的临床试验设计.
研究的目的:
- 测试无人监督的呼吸机设置集群是否能在患有严重BPD的婴儿中识别出不同的生理方法.
- 分析来自重度BPD婴儿多中心队列的呼吸机数据.
主要方法:
- 一个多中心点流行研究的二次分析.
- 使用了来自重度BPD的婴儿的侵入性机械通风数据.
- 沃德的层次聚类分析 (HCA) 应用于平均气道压力 (MAP),正极呼气压力 (PEEP),呼吸速率和吸气时间 (Ti).
主要成果:
- 包括来自14个中心的78名患有严重BPD的婴儿.
- HCA确定了三个独立的集群,具有强大的稳定性.
- 在集群之间观察到PEEP,MAP,率,Ti和峰值吸气压 (PIP) 的显著差异 (p < 0.0001).
结论:
- 在没有监督的情况下对呼吸机设置进行集群,在患有严重BPD的婴儿中发现了三种不同的机械通风方法.
- 需要进行前性试验来确定与BPD表型的关联.
- 需要进一步的研究来评估对呼吸道结果的差异性影响.
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