AARC临床实践指南:自发呼吸试验,以摆脱成人机械通风
Karsten J Roberts1, Lynda T Goodfellow2, Corinne M Battey-Muse3
1Thomas Jefferson University, Philadelphia, Pennsylvania karsten.roberts@jefferson.edu.
这项研究通过建议临床医生避免快速浅呼吸指数并进行带有或没有压力支持的自发呼吸试验 (SBTs) 来简化呼吸器释放. 建议旨在在重症成年人中更快地断奶.
科学领域:
- 关键护理医学 关键护理医学
- 呼吸系统疗法 呼吸系统疗法
- 临床实践指南 临床实践指南
背景情况:
- 对于通风机释放的现有临床实践指南,没有回答的实施问题.
- 需要明确的建议来优化机械通风吸收的过程.
研究的目的:
- 为床边临床医生提供基于证据的建议,以释放呼吸机.
- 解决自发呼吸试验 (SBT) 实施中的特定不确定性.
主要方法:
- 成立了一个指导委员会,专门从事呼吸机释放和医疗图书馆工作.
- 使用了推评估,开发和评估 (GRADE) 的分级方法.
- 制定了关于SBT准备,行为,时间和氧化调整的具体建议.
主要成果:
- 快速浅呼吸指数的计算对于SBT准备情况是不必要的 (有条件的建议,中等的确定性).
- 可以使用或不使用压力支通风进行SBT (有条件的建议,中等的确定性).
- 建议在中午之前进行标准化的每日SBT评估 (有条件的建议,确定性非常低).
- 在SBT期间不应增加吸入氧的分量 (FIO2) (有条件的建议,确定性非常低).
结论:
- 这些建议旨在促进成年重病患者更快地从机械通风中释放出来.
- 这些指导方针侧重于在床上实践实施呼吸机断奶协议.
- 遵守这些建议可能会提高机械通风管理的效率和结果.
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