在非侵入性通风患者中输内管的最佳时间:一项回顾性队列研究
Tatsuhiko Abe1, Toshishige Takagi1, Kazunari Takahashi1
1Department of Intensive Care Jikei University Hospital Tokyo Japan.
Health science reports
|December 13, 2023
概括
对于非侵入性通风 (NIV) 患者来说,最佳的输内管时间至关重要. 在NIV在ICU启动后大约24小时过渡到侵入性通风,与更长的无呼吸器日有关,改善了患者的治疗结果.
科学领域:
- 临界护理医学 临界护理医学
- 呼吸系统医学 呼吸系统医学
- 临床研究 临床研究
背景情况:
- 由于临床证据有限,在重症监护病房 (ICU) 中从非侵入性通风 (NIV) 过渡到侵入性通风的最佳时间尚不清楚.
- 这种不确定性会影响患者的管理和呼吸衰竭的结果.
研究的目的:
- 为了确定在重症监护病房内输管的最佳时间,最初使用非侵入性通风管理的患者.
- 为了确定过渡到侵入性通风的时间和患者的结果之间的关联.
主要方法:
- 在日本东京的一项单中心观察研究中,包括在2013年至2022年期间接受NIV的成年ICU患者.
- 主要结局是28天的侵袭性无呼吸器日.
- 用局部估计的分散图平滑 (LOESS) 和通用线性混合模型来分析输管时间和无呼吸器日之间的关联.
主要成果:
- 在接受NIV治疗的589名患者中,有139人过渡到侵入性通风.
- 在输管时间和28天无呼吸器日之间观察到非线性关联.
- 在NIV启动后大约24小时内输管与最长的28天无呼吸器日有关;稍后的输管减少了这一结果.
结论:
- 对于NIV患者来说,输管存在关键的24小时窗口.
- 在这个窗口内及时输管与无呼吸器日的改善有关,这表明患者康复的潜在好处.
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