在急性低氧性呼吸衰竭中,清醒的倾向性定位:国际专家指导
Ivan Pavlov1, Jie Li2, Aileen Kharat3
1Department of Emergency Medicine, Hôpital de Verdun, Montréal, Québec, Canada.
Journal of critical care
|August 28, 2023
概括
强烈建议在高级呼吸器支上对非输入管的COVID-19患者进行清醒易感定位 (APP). 本指南提供了基于证据的建议,用于急性缺血性呼吸衰竭 (AHRF) 的APP使用.
科学领域:
- 关键护理医学 关键护理医学
- 肺部病理学 肺部病理学
- 传染性疾病 传染性疾病
背景情况:
- 对于COVID-19急性缺血性呼吸衰竭 (AHRF) 的醒着易感定位 (APP) 的采用是不一致的.
- 相互矛盾的试验证据阻碍了APP的常规实施.
- 本指南在各种临床场景中提供了基于证据的APP推.
研究的目的:
- 提供基于证据的建议,用于使用清醒倾斜定位 (APP).
- 澄清APP在管理非输管患者的AHRF中的作用,特别是在COVID-19中.
- 解决在常规临床实践中不一致采用APP的问题.
主要方法:
- 随机临床试验的系统文献搜索.
- 使用GRADE方法的证据摘要和建议开发.
- 国际多学科小组的专业知识和代表性.
主要成果:
- 强烈建议在接受高级呼吸系统支持 (HFNC,CPAP,NIV) 的COVID-19患者中使用APP而不是躺卧.
- 由于RCT证据不足,不建议在接受常规氧气治疗的COVID-19患者中使用APP.
- 由于非COVID-19原因,没有建议在AHRF中使用APP.
结论:
- 建议在高级呼吸系统支持下对COVID-19患者进行常规应用APP.
- 在特定的AHRF人群中,APP是改善结果的关键干预措施.
- 需要在其他AHRF背景下对APP进行进一步的研究.
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