持续的正气道压力与急性缺血性呼吸衰竭的高流量鼻氧疗法:一项随机对照试验
Kazuma Nagata1, Toshiki Yokoyama2, Ryosuke Tsugitomi3
1Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan.
概括
持续正气道压力 (CPAP) 比高流量鼻腔管 (HFNC) 更有效地减少急性低血压呼吸衰竭的输管需求. 这项随机试验发现,CPAP与HFNC相比,显著降低了输管风险.
科学领域:
- 关键护理医学 关键护理医学
- 呼吸系统医学 呼吸系统医学
- 肺部病理学 肺部病理学
背景情况:
- 对于急性呼吸衰竭,初始的非侵入性呼吸支策略,持续正气道压力 (CPAP) 和高流量鼻 (HFNC) 的相对有效性尚不清楚.
- 急性缺血性呼吸衰竭需要有效的呼吸支持,以防止输管治疗和改善患者的治疗结果.
研究的目的:
- 为了比较CPAP与HFNC在降低输管风险和改善急性缺血性呼吸衰竭患者的临床结果方面的疗效.
- 评估至28天内输管时间的主要终点.
主要方法:
- 进行了一项多中心,开放标签,并行组随机对照试验.
- 八十五名急性缺血性呼吸衰竭患者被随机分配给接受CPAP或HFNC.
- 主要结局是28天内满足先前规定的输管标准的时间.
主要成果:
- 与HFNC相比,CPAP显著降低了满足输管标准的风险 (危险比:0.327;p=0.006).
- 虽然CPAP显示了更好的肺氧化,但在输管率,死亡率或呼吸支或住院时间之间没有显著差异.
- 不良事件在CPAP和HFNC组之间是最小的和可比的.
结论:
- 持续正气道压力 (CPAP) 在减轻急性低血压呼吸衰竭患者输管需求方面表现出比高流量鼻腔管 (HFNC) 更高的有效性.
- 在这种患者群体中,CPAP可能是首选的初始非侵入性通风策略.
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