家庭侵入性机械通风儿童的断奶策略
Harutai Kamalaporn1, Aroonwan Preutthipan1, Allan L Coates2
1Department of Pediatrics, Division of Pulmonology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Pediatric pulmonology
|April 9, 2024
概括
在有补偿性肺生长的儿童中,通过家庭机械通风 (HMV) 成功断奶是可能的. 本研究概述了让儿童不再使用HMV的策略,强调准备和逐步断开连接.
科学领域:
- 儿科肺病学 儿科肺病学
- 呼吸系统护理 呼吸系统护理
- 临界护理医学 临界护理医学
背景情况:
- 儿童的家庭机械通风 (HMV) 缺乏标准化的国际断奶指南.
- 补偿性肺生长为儿科患者的HMV断奶成功提供了潜力.
- 来自第三级护理中心的27年的经验告诉我们当前的断奶做法.
研究的目的:
- 总结和介绍基于证据的战略,从HMV. 断奶儿童.
- 提供指导,评估准备为断奶和脱的准备.
- 突出影响儿童HMV奶成功的因素.
主要方法:
- 关于HMV断奶策略的文献综述.
- 来自儿童家庭呼吸护理计划的临床经验分析.
- 确定准备断奶和脱的准备标准.
主要成果:
- 准备奶的条件是血液动力学稳定性,有效咳,低FiO2/PEEP要求和可接受的血液气体.
- 断奶包括白天断开连接,逐渐增加非通风器时间,并可选地过渡到非侵入性支持.
- 成功断奶取决于潜在的疾病,并发症,生长,护理人员的支持和资源.
结论:
- 当孩子准备好时,应该开始断奶,并在急性疾病或增加呼吸力度时停止断奶.
- 脱管前的评估包括说话试验,气管切除术封闭和呼吸道评估 (支气管镜检查,多睡眠镜检查).
- 及时的断管是预防言语延迟,社会问题和与长期使用气管切除术相关的感染风险至关重要的.
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