高流量气管氧的生理效应在从机械通风中断奶的气管切除患者中
Matthijs L Janssen1, Dolf Weller2, Henrik Endeman3
1Department of Intensive Care, Erasmus MC, Rotterdam, the Netherlands; Department of Intensive Care, Franciscus Gasthuis and Vlietland Ziekenhuis, Rotterdam, the Netherlands; and Department of Respiratory Medicine, Erasmus MC, Rotterdam, the Netherlands.
Respiratory care
|May 21, 2024
概括
高流量气管氧 (HFTO) 改善了从通风中断奶的气管切除患者的氧化. 然而,与传统氧气疗法相比,呼吸力和通风仍然相似,这表明需要进一步研究.
科学领域:
- 关键护理医学 关键护理医学
- 呼吸系统生理学 呼吸系统生理学
- 肺部康复治疗 肺部康复治疗
背景情况:
- 高流量气管氧 (HFTO) 越来越多地用于从机械通风中断气管切除患者.
- 缺乏支持HFTO在这个人群中的疗效的临床证据.
- 本系统性审查评估了HFTO在气管切除辅助断奶期间的生理影响.
研究的目的:
- 系统地审查关于HFTO在接受断奶的气管切开术患者的生理影响的研究.
- 确定有关HFTO使用的当前研究中的差距.
- 为未来的研究方向提供信息,以优化断奶策略.
主要方法:
- 在2022年12月之前对观察性和干预性研究进行系统审查.
- 包括通过气管切除术断奶的重症患者.
- 不包括儿童研究,动物模型,仅临床结果和非全文摘要.
主要成果:
- 包括五项研究,比较HFTO (≥50L/分钟) 与常规氧气疗法.
- 在HFTO中,氧化率 (PaO2/FiO2) 和平均气道压力 (Paw) 得到改善.
- 在HFTO和常规疗法之间,终呼吸肺体积 (EELV),潮体积,呼吸力和神经呼吸机驱动器是可比的.
结论:
- HFTO主要在奶期间增强气管切除术患者的氧化,可能是由于流量依赖.
- 呼吸力,肺气化和通风与传统氧气疗法没有显著差异.
- 未来的研究应该调查HFTO对唾液清除和患者报告的呼吸障碍等结果的影响,最好是在断奶过程的早期.
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