怀孕期间的肺部保护性通风:观察性队列研究
Yasaswi Kislovskiy1, Alisse Hauspurg2,3, Chenell Donadee4
1Department of Obstetrics and Gynecology, Women's Institute, Allegheny Health Network, Pittsburgh, Pennsylvania.
机械通风的孕妇经常在所有三个月内接受低潮量通风 (LTVV). 这个队列经历了显著的孕产妇和胎儿并发症,包括高率的早产和胎儿死亡.
科学领域:
- 关键护理医学 关键护理医学
- 产科和妇科 产科和妇科
- 呼吸系统医学 呼吸系统医学
背景情况:
- 机械通风在孕妇患者提出了独特的挑战,因为在怀孕期间生理变化.
- 了解通风策略和结果对于优化这种脆弱人群的护理至关重要.
- 以前的研究还没有完全阐明与孕妇不同的潮体积策略相关的特征和结果.
研究的目的:
- 描述机械呼吸的孕妇患者.
- 在怀孕三季度中评估低潮量通风 (LTVV) 与高潮量通风 (HTVV) 的利用情况.
- 描述与每个通风策略相关的孕产妇和胎儿结果.
主要方法:
- 对需要机械通风24小时以上的孕妇进行回顾性队列研究 (2012年7月 - 2020年8月).
- 定义LTVV为预测体重的每日平均潮体积≤8毫升/公斤;HTVV为>8毫升/公斤.
- 分析了人口,母亲,胎儿的特征,并根据通风策略分层结果.
主要成果:
- 确定了52名孕妇;43名接受LTVV,9名接受HTVV.
- 急性呼吸困难综合征 (ARDS) 影响了73%的患者;感染是通风的常见迹象 (63%).
- 观察到产科并发症的高率 (21% 孕前/孕后),早产 (60%) 和胎儿死亡 (16%).
结论:
- 在所有三个月内,LTVV是孕妇患者使用的主要通风策略.
- 这项研究强调了这一群体中母亲和胎儿发病率和死亡率的重大负担.
- 感染是怀孕期间机械通风的常见原因,在晚期怀孕中,倾斜的定位是可行的.
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