神经肌肉疾病中间歇性腹部压力通风的管理:德尔菲小组共识共识
Anna Annunziata1, Paola Pierucci2, Paolo Innocente Banfi3
1Unit of Respiratory Physiopathology and Rehabilitation, A.O.R.N. "Dei Colli" - Monaldi Hospital, Naples, Italy.
Expert review of respiratory medicine
|June 16, 2023
概括
间歇性腹腔压力通风 (IAPV) 为神经肌肉疾病提供了侵入性通风的替代方案. 这项研究提供了关于IAPV使用的首个专家共识,涵盖指示,设置和管理.
科学领域:
- 呼吸系统医学 呼吸系统医学
- 神经学 神经学
- 医疗器械 医疗器械
背景情况:
- 间歇性腹腔压力通风 (IAPV) 在治疗肌肉发育不良方面具有历史根源,并已扩展到其他神经肌肉疾病 (NMD).
- 对IAPV的重新兴趣源于与气管切割和气管管相关的患病率和死亡率的担忧.
- 目前缺乏确定的指导方针,需要专家的共识,以获得最佳的IAPV应用.
研究的目的:
- 建立医生在NMD患者使用IAPV的共识.
- 为IAPV在临床实践中的实施制定实际建议和指导方针.
主要方法:
- 为了达到专家的共识,采用了经过修改的三步Delphi方法.
- 一个由14名呼吸系统医生和1名精神病学家组成的小组参加了IAPV的广泛经验.
- 按照PRISMA指导方针进行了一次系统的文献审查,以告知共识过程.
主要成果:
- 在两轮投票后,在34个声明上达成共识.
- 该共识涵盖IAPV的关键方面,包括指示,参数设置和程序协议.
- 此外,还就潜在的限制,禁忌,并发症,监测和后续策略达成协议.
结论:
- 这项研究为NMD患者提供了关于IAPV的第一个专家共识.
- 已建立的指导方针为安全有效的IAPV使用提供了框架.
- 这种共识旨在通过标准化IAPV管理来改善患者护理.
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