对重症监护病人的保守与自由氧气疗法:随机对照试验的元分析
Xin-Yu Li1, Bing Dai1, Hai-Jia Hou1
1Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of China Medical University, No.155, Nanjing North Street, Heping District, Shenyang, China.
Annals of intensive care
|April 26, 2024
概括
与自由氧气疗法 (LOT) 相比,保守氧气疗法 (COT) 并没有降低重症监护室 (ICU) 患者的死亡率. 需要进一步的研究来确认COT对特定患者群体的影响.
科学领域:
- 临界护理医学 临界护理医学
- 肺部医学 肺部医学
- 临床试验 临床试验
背景情况:
- 对重症监护室 (ICU) 患者的最佳氧气治疗策略仍然不确定.
- 将保守氧气疗法 (COT) 和自由氧气疗法 (LOT) 进行比较对于改善患者的治疗结果至关重要.
研究的目的:
- 系统地审查和元分析随机对照试验 (RCT),比较ICU患者的COT和LOT.
- 评估COT与LOT在死亡率和其他临床结果方面的疗效和安全性.
主要方法:
- 在主要数据库 (PubMed,Embase,Scopus等) 进行了全面的文献搜索. 在2024年4月之前发表的RCT.
- 包括的研究比较了COT和LOT,主要结果是死亡率和二次结果,包括停留时间和没有机械通风的日子.
主要成果:
- 与LOT相比,对包括10,632名患者在内的13个RCT的分析表明,COT与LOT相比,并没有显著降低30天,90天或最长随访死亡率.
- 根据ICU类型,P/F比率或PaO2.2,在子组分析中没有发现显著差异.
- COT没有影响ICU/住院长度或无血管压缩器时间,但影响了无机械通风的日子.
结论:
- 保守的氧气疗法似乎没有降低一般ICU患者全因死亡率.
- 需要进一步进行高质量的随机对照试验,以确定COT在不同患者亚组中的特定影响.
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