隔膜超声波用于输出管的价值:单盲随机临床试验
1Centro Universitario FMABC, Santo Andre, Brazil.
Critical care research and practice
|September 28, 2023
概括
隔膜超声波 (DUS) 有效地指导机械通风撤回,显示出相似的输出管成功率和低的再输入管风险与ICU患者的标准协议相比. 这种非侵入性工具有助于确定从呼吸器支器断奶的准备程度.
科学领域:
- 临界护理医学 临界护理医学
- 肺部病理学 肺部病理学
- 医疗成像医学成像
背景情况:
- 机械通风 (MV) 患者的日常评估对于成功的输出管是至关重要的.
- 隔膜超声波 (DUS) 是一种潜在的非侵入性工具,用于评估输出管的准备.
- 优化呼吸机断奶可以减少重症监护室 (ICU) 的并发症和成本.
研究的目的:
- 为了比较DUS引导断奶的疗效与MV戒断的常规协议.
- 评估在接受不同断奶策略的患者中重新灌输率和医院死亡率.
主要方法:
- 一个随机的,并行的,单盲的,受控的试验在40名MV的ICU患者身上进行.
- 患者被分配到传统的断奶协议或DUS引导的断奶协议 (1:1比).
- 主要结局包括再灌输率和医院死亡率.
主要成果:
- 在DUS引导和传统组中,输出管的成功率为90%.
- 观察到较低的再化率:在48小时内没有任何一次,在两组中,在2至7天之间只有两次.
- DUS测量协议在指导MV戒断方面表现出有用性,隔膜厚度分数全面评估隔膜功能.
结论:
- DUS是一种潜在的有价值的非侵入性工具,用于指导机械通风患者的输出管决策.
- 在DUS引导的断奶与常规方法之间,没有发现重新灌输率或死亡率的显著差异.
- 未来的研究应该集中在更大的,多中心的试验中,将DUS与传统的临床指数结合起来,以实现多式联络断奶策略.
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