机械吸气在预防急性呼吸衰竭的作用:一项随机对照试验:在重症监护中预防急性呼吸衰竭:一种随机对照试验
Philippe Wibart1, Thomas Réginault1, Margarita Garcia-Fontan1
1Department of Medical Critical Care, Hôpital Pellegrin, Centre Hospitalier Universitaire de Bordeaux, Université de Bordeaux - Bordeaux, France.
机械吸气-排气并没有减少重症监护室获得的衰弱患者的急性呼吸衰竭. 这种干预措施在预防脱口术后呼吸衰竭或改善生存率方面没有显著的益处.
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
- 呼吸系统疗法 呼吸系统疗法
背景情况:
- 在重症监护室获得的虚弱 (ICU-AW) 与输出管后呼吸道并发症的风险增加有关.
- 切口后的急性呼吸衰竭 (ARF) 是ICU-AW患者的一个重大问题.
- 机械吸气-排气 (MIE) 是一种用于帮助分泌物清除和呼吸支持的技术.
研究的目的:
- 评估机械吸气-排气 (MIE) 与胸部物理治疗相结合的机械吸气-排气 (MIE) 在降低急性呼吸衰竭 (ARF) 在重症监护病房获得性虚弱 (ICU-AW) 患者的急性呼吸衰竭.
主要方法:
- 进行了一项前性随机对照开放标签试验.
- 患有ICU-AW (医学研究理事会得分≤48/60) 的患者接受了传统的胸部物理治疗或胸部物理治疗加MIE.
- 评估的结果包括输出管后48小时内ARF,再输入管率,ICU停留时间,28天和90天的死亡率.
主要成果:
- 在对照组 (11.5%) 和MIE (16.4%) 组之间,ARF发病率没有显著差异 (p = 0.60).
- 在各组之间观察到类似的再灌输率,ICU停留时间,28天死亡率和90天生存概率.
- 根据临时分析结果,试验因徒劳而提前终止.
结论:
- 与胸部物理治疗相结合的机械吸气-抽气似乎无法预防ICU-AW患者的抽出术后ARF.
- 该干预措施对死亡率或生存率没有显著影响.
- 由于试验提前结束,建议进行进一步的临床研究.
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