呼吸困难儿童的氧和目标:系统性审查
Sam Louman1, Karlijn J van Stralen1, Mariëlle W H Pijnenburg2
1Spaarne Gasthuis Academy, Spaarne Gasthuis Hospital, Hoofddorp, The Netherlands.
ERJ open research
|October 18, 2023
概括
较低的外周氧和 (SpO2) 值对于呼吸困难的儿童可能是安全的,可能会减少住院和住院时间. 需要进一步的高质量研究来证实这些发现.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 呼吸系统药物 呼吸系统药物
- 基于证据的医学是基于证据的医学.
背景情况:
- 当前的外周氧和 (SpO2) 值为呼吸困难儿童的补充氧气在90-94%之间.
- 这些已确定的SpO2值是基于有限的经验证据.
- 在儿科呼吸困境中,不同的SpO2值的安全性和有效性需要进一步研究.
研究的目的:
- 系统地审查关于儿科呼吸困扰中外周氧和 (SpO2) 值的现有证据.
- 评估不同SpO2值对患者安全和治疗有效性的影响.
- 根据临床指导方针,在患有呼吸困难的儿童中确定最佳的SpO2目标.
主要方法:
- 对2010年1月至2022年1月期间发表的原始文章进行系统审查.
- 纳入标准:比较两个或两个以上SPO2值在儿科呼吸困扰的研究.
- 评估结果:死亡率,神经认知结果,再入院,入院率和住院时间长度;使用RoB-2或ROBINS-I评估的偏差风险.
主要成果:
- 包括七项研究,比较较低的SpO2值 (80-92%) 与更高的值 (92-94%).
- 与较高的值相比,较低的SpO2值显示出同等的安全结果 (死亡率,神经认知,再录取).
- 较低的SpO2值显著降低了多达40%的入院率,并将住院时间减少了10-18小时.
结论:
- 目前小儿呼吸困扰的SpO2值 (90-94%) 可能不必要地高,可能导致住院病例增加.
- 低至88%的SpO2值似乎是安全的,可能会降低住院率和住院时间.
- 需要高质量的证据来验证在临床实践中对患有呼吸困扰的儿童使用较低的SpO2值.
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