儿童严重喘的非侵入性呼吸系统支持:一个多中心队列研究
Brett W Russi1, Alexa R Roberts1, Ignacio F Nievas1
1Division of Pediatric Critical Care Medicine, Johns Hopkins All Children's Hospital, St. Petersburg, Florida.
Respiratory care
|January 30, 2024
概括
加热,加湿,高流量鼻腔管 (HFNC) 越来越多地用于儿科关键性喘,尽管失效率高于双级正气道压力 (BPAP). 然而,与BPAP相比,HFNC的使用导致了不那么侵入性通风.
科学领域:
- 儿科重症监护医学 儿科重症监护医学
- 呼吸系统疗法 呼吸系统疗法
- 喘管理 喘管理
背景情况:
- 非侵入性呼吸系统支持 (NRS) 对儿科关键性喘至关重要.
- 关键的NRS方法包括CPAP,双级正气道压力 (BPAP) 和加热,加湿,高流量鼻 (HFNC).
研究的目的:
- 分析NRS模式对儿科严重喘的处方趋势.
- 根据最初的NRS设备来描述患者的人口统计学,临床特征和住院患者的结果.
主要方法:
- 从125个儿科重症监护室 (2017-2021) 进行了1083名患有严重喘的儿童 (2-17岁) 的回顾性队列研究.
- 主要结果:NRS模式规定了率和趋势.
- 二次结局:人口统计,并发症,严重性指数和NRS失败率 (升级到侵入性通风或不同的NRS).
主要成果:
- 使用HFNC显著增加 (59.7%至71.9%),而BPAP和CPAP则下降.
- 年龄较大,肥胖的儿童死亡率较高,更有可能接受BPAP/CPAP.
- HFNC的失败率比BPAP (2.4%) 高 (7.3%),但随后的侵入性通风率较低 (0.8%对2.4%).
结论:
- HFNC越来越多地成为儿科关键喘的首选NRS,超过BPAP和CPAP.
- 虽然HFNC的失败率较高,但大多数患者在不需要侵入性通风的情况下过渡到BPAP.
- 需要进行进一步的前性试验,以评估患者的舒适度和最佳的治疗治疗,以确保设备的优越性.
关键词:
喘 喘 是一种双层阳性气道压力 双层阳性气道压力持续的正气道压力持续的正气道压力关键性喘是什么意思高流量鼻腔运管 鼻腔运管侵袭性通风通风的使用方法非侵袭性呼吸辅助是一种非侵袭性呼吸辅助.非侵入式通风系统的使用.儿科 儿科 儿科状态 喘病患者更多相关视频
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