透鼻加湿快速灌气通风交换的有效性与标准面罩氧化相比,用于麻醉诱导期间的无呼吸前和无呼吸氧化:基于随机对照试验的元分析
Delai Zheng1, Yi Yao1, Chuan Luo2
1Department of Cardiothoracic Surgery, The First People's Hospital of Neijiang, Neijiang Affiliated Hospital of Chongqing Medical University, Neijiang, Sichuan, China.
PloS one
|April 30, 2024
概括
与面罩通风 (FMV) 相比,透鼻加湿快速灌气通风交换 (THRIVE) 提供更好的氧化前. THRIVE改善了氧化,延长了安全的呼吸暂停时间,并减少了麻醉诱导期间的并发症.
科学领域:
- 麻醉学 麻醉学
- 呼吸系统生理学 呼吸系统生理学
- 关键护理医学 关键护理医学
背景情况:
- 有效的预氧化对于麻醉诱导期间的患者安全至关重要.
- 面罩通风 (FMV) 是一种标准方法,但其有效性可能有限.
- 寻求替代技术来优化氧化和延长呼吸暂停的时间.
研究的目的:
- 为了评估透鼻加湿快速灌气通风交换 (THRIVE) 在呼吸暂停前和呼吸暂停前的氧化疗法的有效性.
- 为了比较THRIVE与麻醉诱导期间的面罩通风 (FMV).
- 综合来自随机对照试验 (RCT) 关于 THRIVE 疗效的当前证据.
主要方法:
- 在主要数据库 (Medline,EMBASE,Web of Science,Cochrane Library,CNKI) 进行了系统的文献搜索,截至2023年12月22日.
- 包括的研究是随机对照试验 (RCT),比较THRIVE和FMV.
- 主要结局包括PaO2,PaCO2和安全的呼吸暂停时间;次要结局包括氧气不和,EtCO2和并发症.
主要成果:
- 分析了12个涉及804名患者的RCT.
- 与FMV相比,THRIVE显示了显著更高的输液后PaO2 (MD = 82.90mmHg) 和更长的安全呼吸暂停时间 (MD = 103.81s).
- 兴旺显著降低了氧气不和 (RR = 0.28) 和胃 insufflation (RR = 0.26) 的发生率.
结论:
- 在麻醉诱导过程中,THRIVE 在呼吸暂停前和呼吸暂停氧化方面比FMV更有效.
- 兴旺改善氧化,延长安全的呼吸暂停时间,并降低并发症风险.
- THRIVE代表了一种有价值的新氧化技术,用于手术患者.
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