通过非侵入性呼吸辅助方式产生气溶:系统性审查和元分析
Madeline X Zhang1, Thijs A Lilien2, Faridi S van Etten-Jamaludin3
1Institute of Physics, Van der Waals-Zeeman Institute, University of Amsterdam, Amsterdam, the Netherlands.
JAMA network open
|October 11, 2023
概括
高流量鼻氧和非侵入性通风与空气中的病原体检测或气溶生成的增加无关. 这些发现表明当前的感染控制实践对于这些程序可能不需要区分.
科学领域:
- 呼吸系统医学 呼吸系统医学
- 传染病控制和控制传染病
- 肺部生理学 肺部生理学
背景情况:
- 从历史上看,高流量鼻氧 (HFNO) 和非侵入性通风 (NIV) 被归类为气溶生成程序 (AGP).
- 这种分类需要专门的感染预防和控制 (IPC) 措施.
- 支持这种分类的证据需要重新评估.
研究的目的:
- 系统地评估现有证据,将HFNO和NIV与带有病原体的气溶和气溶产生联系起来.
- 确定HFNO和NIV是否应该继续被归类为AGP.
主要方法:
- 在主要数据库 (PubMed/MEDLINE,EMBASE,CINAHL) 和临床试验.gov进行了全面的系统搜索.
- 包括的研究是观察性或 (准) 实验性,涉及接受HFNO或NIV的患者或健康志愿者.
- 数据提取和偏差风险评估由三个独立审查员进行,并对观察数据进行了元分析.
主要成果:
- 包括24项研究,在HFNO期间对SARS-CoV-2的5项研究的元分析显示,与带有病原体的气溶没有关联.
- 在NIV期间对SARS-CoV-2的两项研究的元分析也发现与带有病原体的气溶没有关联.
- 在健康志愿者身上进行的研究没有报告HFNO或NIV的气溶颗粒产生临床相关的增加.
结论:
- 这次系统审查和元分析没有发现支持将HFNO或NIV归类为AGP的证据.
- 这些发现表明,目前的IPC实践可能不需要区分这些模式.
- 进一步的研究可能会改进对呼吸辅助过程中气溶生成的理解.
相关概念视频
Mechanical Ventilation III: Noninvasive Ventilation
146
Noninvasive positive-pressure ventilation (NIPPV), continuous positive airway pressure (CPAP), and bilevel positive airway pressure (BiPAP) are essential methods in respiratory care. These ventilation techniques offer unique benefits for patients with various respiratory conditions, providing adequate support without requiring intubation. Let's explore how each method is crucial in improving patient outcomes and enhancing respiratory therapy.
Noninvasive Positive-Pressure Ventilation...
Noninvasive Positive-Pressure Ventilation...
146
Mechanical Ventilation II: Invasive Ventilation
173
Ventilators are essential medical equipment used to aid patients with respiratory difficulties. Their primary function is to assist or replace spontaneous breathing by providing mechanical ventilation. There are two general classes of mechanical ventilators: negative-pressure and positive-pressure ventilators.
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...
173
Ventilatory Modes
185
Mechanical ventilators are life-saving devices that support or replace spontaneous breathing. They deliver breaths to patients through varying methods known as ventilator modes. Understanding these modes is critical for healthcare providers managing patients with respiratory failure.
There are three ventilatory modes: full support, partial support, and spontaneous. These are described below.
Full Support Modes
Full support modes include controlled mechanical ventilation, continuous mandatory...
There are three ventilatory modes: full support, partial support, and spontaneous. These are described below.
Full Support Modes
Full support modes include controlled mechanical ventilation, continuous mandatory...
185
Acute Respiratory Failure-V
144
The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...
Ensure that patients are monitored continuously for their response to therapy, including changes in...
144
Drugs Used in Lower Respiratory Disorders: Overview
462
Lower respiratory tract disorders present challenges that often require skilled and nuanced approaches for effective management. Common ailments, such as asthma and chronic obstructive pulmonary disease (COPD), have prompted the development of intricate treatment strategies involving bronchodilators and anti-inflammatory drugs, each tailored to ease breathing and revitalize the lungs.
Bronchodilators, the first step of respiration enhancement, come in various forms, each with its own mechanism...
Bronchodilators, the first step of respiration enhancement, come in various forms, each with its own mechanism...
462
Factors Affecting Pulmonary Ventilation
1.4K
Besides the pressure difference between the external environment and the lungs, the airflow rate and ease of pulmonary ventilation are also influenced by three other factors: surface tension of the fluid in the alveoli, compliance of the lungs, and airway resistance.
Alveolar Surface Tension
The alveolar fluid lines the luminal surface of the alveoli and exerts a force called surface tension. This force is caused by the polar water molecules in the liquid being more strongly attracted to each...
Alveolar Surface Tension
The alveolar fluid lines the luminal surface of the alveoli and exerts a force called surface tension. This force is caused by the polar water molecules in the liquid being more strongly attracted to each...
1.4K


