以36°C为目标的温度管理是呼吸机相关肺炎的危险因素
Masaru Nasuno1,2, Yukari Yokoyama3, Mitsuo Motobayashi2,4,5,6
1Department of Medical Genetics, Shinshu University School of Medicine, Matsumoto, Japan.
概括
在36°C的治疗常温和甲基前尼索隆脉冲疗法是儿童呼吸器相关肺炎 (VAP) 的潜在危险因素. 这项研究强调了在需要机械通风的儿科患者中导致VAP的关键因素.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 传染病流行病学 传染病流行病学
- 呼吸系统药物 呼吸系统药物
背景情况:
- 关于儿童呼吸机相关肺炎 (VAP) 风险因素的数据有限.
- 治疗性低温是已知的VAP风险因素在成年人中,但正常热的作用是不清楚的.
- 这项研究的重点是确定儿科患者的VAP风险因素,特别是检查治疗性正常热量的影响.
研究的目的:
- 调查儿童呼吸机相关肺炎 (VAP) 的危险因素.
- 为了评估治疗性正常热量和儿科患者的VAP发作之间的关联.
- 确定可能增加机械通风儿童VAP风险的具体干预措施.
主要方法:
- 在儿童的临床特征的回顾性分析机械通风超过48小时.
- 定义为在机械通风启动后七天内发生的VAP发作.
- 统计分析包括单变量分析,卡普兰-梅尔图形和日志等级测试以确定风险因素.
主要成果:
- 在288名 (2.4%) 的儿科患者中,有7名患有VAP.
- 在VAP和非VAP组之间没有发现临床背景的显著差异.
- 在36°C的治疗温度管理 (TTM) 和甲基prednisolone (mPSL) 脉冲疗法被确定为VAP的显著风险因素.
结论:
- 在36°C的治疗温度管理 (TTM) 可能会增加儿科患者VAP的风险.
- 甲基prednisolone (mPSL) 脉冲疗法是儿童群体中VAP的潜在危险因素.
- 这些发现表明需要重新考虑温度管理方案和在机械通风儿童的皮质类固醇的使用,以防止VAP.
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