难以口罩通风的患病率和风险因素:系统性审查和元分析
Kuo-Chuan Hung1, Min-Hsiang Chuang2, Fu-Chi Kang3
1School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung City, Taiwan; Department of Anesthesiology, Chi Mei Medical Center, Tainan City, Taiwan.
Journal of clinical anesthesia
|July 6, 2023
概括
这项研究确定了13个关键风险因素,导致难以进行口罩通风 (MV),包括部辐射和肥胖. 这些发现为临床医生提供了基于证据的参考资料,用于预测和管理具有挑战性的口罩通风场景.
科学领域:
- 麻醉学 麻醉学
- 关键护理医学 关键护理医学
- 呼吸系统医学 呼吸系统医学
背景情况:
- 难以口罩通风 (MV) 在麻醉中构成了重大挑战.
- 识别预测性风险因素对于患者安全和有效的气道管理至关重要.
研究的目的:
- 系统地识别和评估难以口罩通风 (MV) 的风险因素的预测力.
- 为临床医生提供以证据为基础的参考资料,用于预测在接受麻醉诱导的成年患者中困难的MV.
主要方法:
- 20项观察性研究的元分析.
- 在EMBASE,MEDLINE,Google Scholar和Cochrane图书馆 (开始至2022年7月) 的系统文献搜索.
- 在超过20%的合格研究中报告的与呼吸道或患者相关的风险因素的分析.
主要成果:
- 确定了13种难以预测MV的风险因素,具有显著的预测强度 (所有p < 0.05).
- 最重要的预测因素包括部辐射 (OR=5.0),部周长增加 (OR=4.04) 和阻塞性睡眠呼吸暂停 (OSA) (OR=3.61).
- 困难的MV的患病率在一般人群中为6.1%,在肥胖患者中为14.4%.
结论:
- 该研究确定了13种常见的风险因素及其对难以使用的MV的预测优势.
- 这些发现为临床医生提供了一个有价值的以证据为基础的工具,以预测和管理困难的口罩通风.
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