机械通风儿童的限制与常规/自由维护液体策略:一个开放式随机试验 (ReLiSCh试验)
Shubham Charaya1, Suresh Kumar Angurana2, Karthi Nallasamy3
1Department of Pediatrics, Advanced Pediatrics Centre (APC), Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.
机械通风儿童的限制液体策略显示了较低的流体过载和死亡率的趋势. 这种方法也导致了无通风和无PICU日数显著增加,这表明恢复更好.
科学领域:
- 儿科重症监护医学 儿科重症监护医学
- 流体管理流体管理
- 机械通风机械通风机械通风
背景情况:
- 流体过载 (FO) 是机械通风儿童的常见并发症.
- 最佳的流体管理策略对于改善重症儿童的治疗结果至关重要.
研究的目的:
- 为了比较限制与通常/自由维护流体策略对机械通风儿童流体过载的影响.
主要方法:
- 一个开放的随机对照试验,涉及100名血液动力稳定,机械通风的北印度儿科重症监护室 (PICU) 的儿童.
- 儿童被随机分配,接受40% (限制组) 或70-80% (通常/自由组) 的维持液体.
- 主要结局是第7天累积液体过载百分比 (FO%),次要结局包括器官功能障碍得分,无通风日 (VFD),无PICU日 (PFD) 和死亡率.
主要成果:
- 与通常/自由派组相比,受限制组显示了较低累积FO% (7.6%与9.5%) 的非显著趋势,以及较低的FO%>10% (12%与26%) 的儿童比例.
- 限制组在前5天接受的液体体积显著减少,并且VFD (23 vs. 17天) 和PFD (19 vs. 15天) 显著增加.
- 在受限组中观察到较低死亡率的趋势 (8%对16%).
结论:
- 在机械通风儿童中,限制维护流体策略与减少流体过载和死亡率的趋势有关.
- 这一策略还导致大大改善了无通风和无PICU的日子.
- 在这种儿科患者群体中,限制液体的使用似乎是有益的,因此需要进一步调查.
更多相关视频
09:31Normothermic Negative Pressure Ventilation Ex Situ Lung Perfusion: Evaluation of Lung Function and Metabolism
Published on: February 14, 2022
06:22Surfactant Depletion Combined with Injurious Ventilation Results in a Reproducible Model of the Acute Respiratory Distress Syndrome ARDS
Published on: April 7, 2021
相关概念视频
Acute Respiratory Failure-V
Ensure that patients are monitored continuously for their response to therapy, including changes in...
Mechanical Ventilation II: Invasive Ventilation
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...
Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
Oxygen Delivering System II: Venturi Mask and Transtracheal Oxygen
Venturi Mask
The Venturi mask, named after the Venturi effect, is designed to deliver precise oxygen concentrations. It consists of a large tube with an oxygen inlet that narrows down, causing a pressure drop that pulls air in through adjustable side ports. The mask is a lightweight,...
Ventilatory Modes
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...
Cardiopulmonary Resuscitation II: ACLS Airway Management
