在儿童阻塞性睡眠呼吸暂停中CPAP失败后,平均体积保证的压力支作为救援疗法:一项回顾性案例系列研究
Victor T Peng1, Nauras Hwig1, Anayansi Lasso-Pirot2
1Sleep Disorders Center, University of Maryland Medical Center, Baltimore, Maryland, MD 21201, USA.
The open respiratory medicine journal
|November 2, 2023
概括
平均体积保证压力支 (AVAPS) 在持续正气道压力 (CPAP) 失败时有效治疗阻塞性睡眠呼吸暂停 (OSA) 的儿童. AVAPS显著降低了呼吸暂停-呼吸暂停指数 (AHI),并解决了导致CPAP失败的问题.
科学领域:
- 儿科睡眠医学 儿科睡眠医学
- 呼吸系统生理学 呼吸系统生理学
- 医疗器械技术 医疗器械技术
背景情况:
- 持续正气道压力 (CPAP) 是儿童在腺切除术后的残留阻塞性睡眠呼吸暂停 (OSA) 的常见治疗方法.
- 然而,一些儿童在CPAP定位方面遇到了挑战,需要使用替代通风策略.
研究的目的:
- 为了评估平均体积保证压力支 (AVAPS) 在患有阻塞性睡眠呼吸暂停 (OSA) 的儿科患者的有效性,这些患者对CPAP定位没有充分反应.
- 评估AVAPS作为一个可行的替代方案来管理复杂的儿科OSA病例.
主要方法:
- 一个回顾性,单中心的研究包括儿童 (1-17岁) 经过多睡眠学确认的OSA,在CPAP失败后接受了AVAPS定位.
- 在AVAPS治疗前后分析了临床特征和多睡眠学参数 (包括呼吸暂停-呼吸暂停指数 (AHI)).
主要成果:
- 九名儿科患者符合纳入标准;89%是男性,平均年龄为6.7岁.
- 导致CPAP失效的原因包括不受控制的AHI (33%),低通风 (33%),治疗引起的中央睡眠呼吸暂停 (22%) 和CPAP不耐受 (11%).
- 与CPAP相比,AVAPS显著减少了AHI (42.5比24.6,p=0.008),并解决了所有患者中导致CPAP失败的潜在问题.
结论:
- 对于患有OSA的儿童而言,AVAPS是一种有效的治疗选择,这些儿童未能通过CPAP定位.
- AVAPS提供了优异的AHI降低,并解决了CPAP治疗失败的具体原因在这个儿科患者群体.
相关概念视频
Cardiopulmonary Resuscitation II: ACLS Airway Management
15
Airway management is a key skill in emergency and critical care settings, as maintaining a clear airway is essential for adequate oxygenation and ventilation.Head Tilt-Chin Lift TechniqueThe head tilt-chin lift maneuver is an essential technique primarily used in patients without suspected cervical spine injuries. To perform this maneuver, one hand is placed on the patient’s forehead, and gentle pressure is applied backward to tilt the head. The fingertips of the other hand are positioned...
15
Mechanical Ventilation III: Noninvasive Ventilation
128
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...
128
Ventilatory Modes
180
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...
180
Acute Respiratory Failure-V
143
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...
143
Treatment for Pulmonary Arterial Hypertension: Oxygen Therapy for Respiratory Failure
233
Oxygen therapy has emerged as a significant tool in enhancing the quality of life for patients suffering from pulmonary arterial hypertension (PAH). While this therapy has principally been studied on patients with significant hypoxemia, this therapeutic approach helps prevent potential organ damage and can be administered in the comfort of one's home.
Oxygen therapy is vital in increasing and maintaining blood oxygen levels in PAH patients. As a result, it aids in reducing fatigue,...
Oxygen therapy is vital in increasing and maintaining blood oxygen levels in PAH patients. As a result, it aids in reducing fatigue,...
233
Cardiopulmonary Resuscitation I: Adult
17
Cardiopulmonary resuscitation, or CPR, is a life-saving emergency procedure performed when a person's heart has stopped beating or they are no longer breathing. The foundation of CPR is Basic Life Support (BLS), which focuses on the early recognition of cardiac arrest, the immediate start of high-quality chest compressions, and the timely use of an automated external defibrillator (AED).Assessing Responsiveness and Checking the Carotid PulseWhen approaching an unresponsive person, first ensure...
17


