在COVID-19患者中,高流量鼻腔管和常规氧气治疗之间的比较:系统性审查和元分析
Jian-Chao Wang1, Yun Peng2, Bing Dai3
1Department of Neurosurgery, The Second Hospital of Jiaxing, Jiaxing, Zhejiang, China.
Therapeutic advances in respiratory disease
|January 17, 2024
概括
与常规氧气疗法 (COT) 相比,高流量鼻腔管 (HFNC) 疗法可能会减少急性缺血性呼吸衰竭 (AHRF) 的COVID-19患者的输入管的需要. 这种好处在严重病例和ICU设置中尤为明显.
科学领域:
- 关键护理医学 关键护理医学
- 呼吸系统医学 呼吸系统医学
- 传染性疾病 传染性疾病
背景情况:
- 高流量鼻腔管 (HFNC) 和常规氧疗法 (COT) 是急性低血压呼吸衰竭 (AHRF) 的COVID-19患者的关键呼吸支持方法.
- 在这个患者群体中,关于HFNC和COT之间输管风险的比较存在相互矛盾的证据.
研究的目的:
- 在COVID-19患者中系统地综合比较HFNC和COT对AHRF的证据.
- 评估相关亚群的结果,包括输管率和死亡率.
主要方法:
- 一个系统的审查和元分析,遵循PRISMA指南.
- 包括随机对照试验和观察性研究,将HFNC与COT在COVID-19 AHRF患者中进行比较.
- 主要结局:输管和死亡率;次要结局:氧化指数 (PaO2/FiO2),呼吸速率和停留时间.
主要成果:
- 分析了包括5732名患者在内的20项研究.
- 与COT相比,HFNC显示输管风险显著降低 (OR=0.61,p=0.0009).
- 亚组分析显示,在基线PaO2 / FiO2 <200 mmHg的患者和ICU设置中,HFNC的输管风险降低.
结论:
- 在COVID-19患有AHRF的患者中,HFNC可能会减少气管管道输液的需要.
- 对于减少输管的HFNC的好处在严重低氧化症 (PaO2 / FiO2 < 200 mmHg) 和被送往重症监护室的患者中更加明显.
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