咳的声度评估预测出口失败:SonoWean-一个概念验证研究
Vincent Bonny1,2, Jeremie Joffre1,2, Paul Gabarre1
1Service de Médecine Intensive Réanimation, Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpital Saint-Antoine, 184 Rue du Faubourg Saint-Antoine, 75571, Paris Cedex 12, France.
Critical care (London, England)
|September 25, 2023
概括
使用声度测量量咳强度的量化可能有助于识别患有侵入性机械通风 (IMV) 后排泄失败风险的患者. 较低的Sonoscore,衡量咳量,预测出口失败,有助于临床决策.
科学领域:
- 关键护理医学 关键护理医学
- 呼吸系统生理学 呼吸系统生理学
- 医学声学 医学声学
背景情况:
- 输出失败是机械通风患者死亡率增加的重要预测因素.
- 不有效的咳是排泄失败的潜在原因,但客观量化仍然很困难.
研究的目的:
- 评价咳强度的声度评估对预测浸透性机械通风 (IMV) 断奶的患者排泄失败的有用性.
- 引入和验证"Sonoscore"作为咳有效性的定量衡量标准.
主要方法:
- 招募了一组106名在IMV治疗24小时以上的患者,他们完成了自发T管呼吸试验 (SBT).
- 在SBT结束时,对三次连续咳进行了定量声度评估,平均咳量以分贝计算,称为Sonoscore.
- 统计分析,包括ROC曲线分析,用于确定Sonoscore用于输出失败的预测值.
主要成果:
- 在14%的患者中发生了输出失败.
- 与成功 (75 dB) (P < 0.001) 患者相比,失败的患者的Sonoscore (58 dB) 显着较低 (P < 0.001).
- 索诺斯科尔是一个强有力的预测器的输出失败 (AUC = 0.91),值<67.1dB显示高灵敏度 (93%) 和特异性 (82%).
结论:
- 咳强度的声度评估,量化为Sonoscore,是识别患有脱口失败高风险的患者的宝贵工具.
- 这一客观措施可以帮助临床医生在断奶过程中从侵入性机械通风中管理患者.
- 进一步的研究可能会完善声度计在呼吸护理中的应用.
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