多中心,并行,开放标签,双臂,随机对照试验对电阻断层扫描导向与低PEEP/FiO2表导向PEEP设置的预后:试验协议:一个试验协议
HouPeng Wong1, Yi Chi1, Rui Zhang2
1Department of Critical Care Medicine, Peking Union Medical College Hospital, Beijing, China.
BMJ open
|February 2, 2024
概括
这项研究比较了电阻断层扫描 (EIT) 引导的阳性末尾呼气压 (PEEP) 定位与急性呼吸困扰综合征 (ARDS) 患者的标准低PEEP/FiO2表策略. 主要结果是28天的生存期,旨在通过个性化通风改善死亡率.
科学领域:
- 关键护理医学 关键护理医学
- 呼吸系统生理学 呼吸系统生理学
- 医疗成像医学成像
背景情况:
- 电阻断层扫描 (EIT) 提供了实时肺部监测的潜力.
- 之前的研究表明,EIT可以通过量化膜缩和过度张张力来指导正极呼吸压力 (PEEP) 定位.
- 优化PEEP对于管理急性呼吸困扰综合征 (ARDS) 至关重要.
研究的目的:
- 为了比较EIT指导的PEEP定位与ARDS网络低PEEP/FiO2表策略的有效性.
- 评估机械通风ARDS患者对死亡率和其他临床结果的影响.
- 评估EIT在ARDS个性化机械通风中的作用.
主要方法:
- 一个平行,双臂,多中心,随机对照试验.
- 在机械呼吸下患有ARDS的患者被分层和随机化.
- 干预组接受了招聘机动和EIT引导的PEEP;对照组接受了标准的低PEEP/FiO2表策略.
主要成果:
- 主要结局是28天的生存期.
- 二次结果将包括ARDS管理的其他临床指标.
- 统计分析包括Kaplan-Meier的生存率和t-test/Mann-WhitneyU的其他数据.
结论:
- 这项研究旨在确定EIT引导的PEEP是否可以改善ARDS患者的生存率.
- 这些发现可能会影响重症监护室的机械通风策略.
- 结果将通过同行评审的出版物传播.
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