在胃肠内镜检查期间,高流量鼻氧化. 系统审查和元分析
Michele Carron1, Enrico Tamburini1, Bijan Safaee Fakhr1
1Department of Medicine - DIMED, Section of Anaesthesiology and Intensive Care, University of Padua, Padua, Italy.
高流量鼻氧 (HFNO) 与常规氧气疗法 (COT) 相比,可以减少胃肠内镜期间的低氧事件. 然而,HFNO的益处可能因患者因素和临床情况而异.
科学领域:
- 医学研究 医学研究
- 临床干预是指临床干预.
- 患者安全 患者安全
背景情况:
- 高流量鼻氧 (HFNO) 通过减轻低氧症,可以提高胃肠内镜期间的患者安全.
- 在这种情况下,HFNO的好处程度需要进一步澄清.
研究的目的:
- 评估HFNO与常规氧气疗法 (COT) 在预防胃肠内镜期间缺氧的疗效.
- 评估二次结果,包括救援演习,程序中断和不良事件.
主要方法:
- 在主要数据库 (PubMed,Scopus,Web of Science,Cochrane Library) 中进行系统的文献搜索.
- 包括六项随机对照试验,涉及2867名在深度镇静下接受胃肠内镜检查的患者.
- 进行了元分析和后期试验序列分析.
主要成果:
- 与COT相比,HFNO显著降低了脱事件 (5.2%与27.2%) 和严重的脱 (<90%SpO2) (1.8%与12.6%相比).
- 较低的救援操作率 (4.7%对比34.3%),程序中断 (0.4%对比6.7%) 和不良事件 (18.7%对比21%) 被观察到与HFNO.
- 亚组分析表明,HFNO对肥胖和非肥胖患者都有好处,并且HFNO治疗持续时间不同,尽管注意到异质性.
结论:
- 与COT相比,HFNO在胃肠内镜检查期间与较少的缺血事件有关.
- HFNO的临床适用性可能会受到患者特征和特定的程序背景的影响.
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