在机械通风的儿科患者中,开放式与封闭式吸气:随机对照试验
Subhranshu Sekhar Dhal1,2, Rajiv Aggarwal1, Hiremath Sagar1
1Department of Pediatrics, Narayana Hrudayalaya Institute of Medical Sciences, Bangalore, Karnataka, India.
Indian journal of pediatrics
|March 13, 2024
概括
封闭的气管吸气系统 (CTSS) 和开放的气管吸气系统 (OTSS) 在儿科患者中显示出类似的呼吸器相关肺炎 (VAP) 发生率. 然而,CTSS与更多与感染相关的呼吸器相关疾病 (IVAC) 有关.
科学领域:
- 关键护理医学 关键护理医学
- 儿科肺病学 儿科肺病学
- 传染病控制和控制传染病
背景情况:
- 呼吸机相关肺炎 (VAP) 是机械呼吸的儿科患者的一个重大问题.
- 气管吸入对于呼吸道管理至关重要,但可以引入病原体.
- 封闭的气管吸收系统 (CTSS) 和开放的气管吸收系统 (OTSS) 都被使用,报告的疗效不同.
研究的目的:
- 为了比较CTSS与OTSS在减少儿科患者VAP发病率方面的疗效.
- 评估CTSS和OTSS对心肺呼吸系统参数,死亡率和输管时间的影响.
- 评估两种吸气系统之间感染相关的呼吸机相关疾病 (IVAC) 的发生率.
主要方法:
- 一个单中心,并行组,开放标签,随机对照研究与1:1分配.
- 116名需要机械通风的儿科患者被随机分配到CTSS或OTSS.
- 记录了人口,临床,实验室参数和治疗结果.
主要成果:
- 在CTSS和OTSS组中,VAP的总体发病率相似 (7.75%).
- 与OTSS组相比,在CTSS组中观察到的IVAC数量显著增加 (RR 3.5).
- 在CTSS组中,氧和 (SpO2) 在吸管后得到更好的维持 (p=0.001),而死亡率和输管日相似.
结论:
- 在儿科患者中,VAP的发生率在CTSS和OTSS之间是可比的.
- 尽管VAP率相似,但CTSS可能与IVAC的风险更高有关.
- 需要进一步的研究来优化儿科机械通风的吸入策略.
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