一个尺寸适合所有吗? 关于不同呼吸道疾病的慢性呼吸系统支持的最新情况
Annalisa Carlucci1,2, Maxime Patout3,4, João Carlos Winck5,6
1Dipartimento di Medicina e Chirurgia Malattie dell'Apparato Respiratorio, Università degli Studi dell'Insubria, Varese, Italy.
Breathe (Sheffield, England)
|July 26, 2023
概括
家庭非侵入性通风 (HNIV) 对COPD,OHS和NMD有好处. 量身定制HNIV启动和考虑睡眠呼吸暂停等同时存在的疾病是成功治疗和改善患者结果的关键.
科学领域:
- 呼吸系统医学 呼吸系统医学
- 肺部生理学 肺部生理学
- 睡眠医学 睡眠医学
背景情况:
- 家庭非侵入性通风 (HNIV) 是为了改善患者在各种呼吸道疾病的结果而建立的.
- 有效的HNIV管理需要了解不同疾病的特定征兆和启动策略.
研究的目的:
- 概述在慢性阻塞性肺病 (COPD),肥胖低通风综合征 (OHS) 和神经肌肉疾病 (NMD) 中启动HNIV的指示和方法.
- 突出早期检测呼吸系统变化和同时存在的疾病的重要性,以优化HNIV治疗.
主要方法:
- 目前文献和临床指导方针的审查,用于在COPD,OHS和NMD中启动HNIV.
- 讨论诊断工具,如氧镜和呼吸道测谎仪,用于检测睡眠相关的呼吸系统问题.
- 考虑同时存在的阻塞性睡眠呼吸暂停 (OSA) 以及其对治疗策略的影响.
主要成果:
- 在COPD治疗中,HNIV的成功需要显著的白天头皮增大和高强度的支持.
- 在NMD和OHS的早期呼吸系统变化最好在睡眠期间使用多睡眠学识别.
- 持续正气道压力 (CPAP) 可能是同时存在OSA的超患者的第一线治疗方法.
结论:
- 在COPD,OHS和NMD之间,HNIV管理有很大的差异,需要量身定制的方法.
- 解决并存的OSA和整合干预措施,如体重管理在OHS对于治疗成功至关重要.
- 远程监测有望改善HNIV标位和长期患者随访.
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