非侵入性通风或CPAP用于小婴儿的输管后支持
Andrew G Miller1, Karan R Kumar2, Bhargav S Adagarla3
1Division of Pediatric Critical Care Medicine, Duke University Medical Center, Durham, North Carolina; and Respiratory Care Services, Duke University Medical Center, Durham, North Carolina. Andrew.g.miller@duke.edu.
Respiratory care
|July 25, 2023
概括
在高风险的婴儿中,除后的非侵入性通风 (NIV) 或CPAP支持显示了43%的再输入率. 救援支持,酸性化和较低的NIRS与重新化需求有关.
科学领域:
- 儿科重症监护医学 儿科重症监护医学
- 呼吸系统支持 呼吸系统支持
- 新生儿通风系统 新生儿通风系统
背景情况:
- 有限的数据存在于非侵入性通风 (NIV) 或持续的正气道压力 (CPAP) 的婴儿高风险的输出失败.
- 本研究详细介绍了在儿科重症监护室 (PICU) 用于术后支的NIV或CPAP的使用经验.
研究的目的:
- 为了评估使用NIV或CPAP在输出管后婴儿的有效性和结果.
- 在这个高风险人群中确定与再输卵相关的因素.
主要方法:
- 一项对51名婴儿 (体重小于10公斤) 的回顾性研究,这些婴儿在PICU中接受NIV或CPAP治疗.
- 收集的数据包括人口统计,病史,支类型,生理参数 (生命体征,脉冲氧计,NIRS,气体交换),支设置和再输液状态.
- 支持被分为预防性 (计划) 或救援 (在24小时内启动) 的类别,在成功抽管和重新输管组之间进行统计比较.
主要成果:
- 整体再灌输率为43% (51名婴儿中有22名婴儿).
- 与预防性支持 (28%) 相比,救援支持与明显更高的再化率 (58%) 相关.
- 与再输入管相关的因素包括先前的心脏手术,酸化 (pH <7.35),较低的体内近红外光谱 (NIRS) 值,以及更高的支设置 (吸入/呼气正气道压力,FiO2).
结论:
- 在高危婴儿中,术后的NIV或CPAP与43%的大量再输液率有关.
- 酸化症,心脏手术史,下体内NIRS,增加的支持需求,以及需要救援支持是重新输管的预测因素.
- 需要进一步的研究,以优化NIV/CPAP策略,以适应这个脆弱的婴儿群体.
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