增量PEEP定位对接受紧急腹腔切除术的患者术后肺部并发症的影响:一项随机对照试验
Emmanuel Easterson Ernest1, Sulagna Bhattacharjee1, Dalim K Baidya1
1Department of Anaesthesiology, Pain Medicine & Critical Care, All India Institute of Medical Sciences, Room No: 5013, Teaching Block, Ansari Nagar, New Delhi, 110019, India.
Journal of clinical monitoring and computing
|November 16, 2023
概括
在紧急手术患者中,个性化阳性末尾呼气压 (PEEP) 并没有减少手术后的肺部并发症. 这种策略也没有增加低血压或心等不良事件.
科学领域:
- 麻醉学 麻醉学
- 关键护理医学 关键护理医学
- 呼吸系统医学 呼吸系统医学
背景情况:
- 手术后的肺部并发症 (PPC) 显著增加了住院和医院费用.
- 紧急手术是PPC的一个已知的风险因素.
- 个性化正极呼吸压力 (PEEP) 策略可以减轻PPC.
研究的目的:
- 调查以最低驱动压力为基础的增量PEEP定位是否会减少PPC在接受重大紧急腹腔切除术的成年患者中.
- 为了比较个性化的PEEP定位与5cmH2O的固定PEEP.
主要方法:
- 168名接受重大紧急腹腔切除术的成年患者被随机分组.
- 一组接受了基于最低驾驶压力的PEEP标位;另一个接受了固定PEEP (5cmH2O).
- 主要结局是PPC直至术后第7天.
主要成果:
- 术后第7天的PPC风险在各组之间是相似的 (RR 0.81; p=0.25).
- 在手术内低血压,无氧日,住院,重症监护室住院或死亡率方面没有发现显著差异.
- 个性化PEEP并没有降低PPC,也没有增加低血压或心拍.
结论:
- 基于最低驾驶压力的个性化PEEP策略并没有降低重大紧急腹腔切除术中PPC的发生率.
- 这种PEEP定位方法是安全的,没有增加不良事件.
- 进一步的研究可能会探索其他PEEP策略或患者群体.
相关概念视频
01:26Endoscopic Studies II: Thoracocentesis
282
Thoracentesis(Thoracocentesis), commonly known as pleural tap, is a medical procedure where a 22 gauge needle is inserted into the pleural space, the area between the lung and chest wall. This procedure is commonly performed to diagnose or treat various respiratory disorders.
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
282
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
10
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
10