替代自发呼吸试验技术的比较有效性:随机试验的系统性审查和网络元分析
Karen E A Burns1,2,3,4, Behnam Sadeghirad5,6, Maryam Ghadimi5
1Departments of Critical Care Medicine and Medicine, Unity Health Toronto, St. Michael's Hospital, 30 Bond Street, 4-045 Donnelly Wing, Toronto, ON, M5B 1W8, Canada. Karen.burns@unityhealth.to.
Critical care (London, England)
|June 7, 2024
概括
在自发呼吸试验 (SBT) 期间增加压力可以提高初始成功率和输出管率. 然而,一些方法,如压力支 (PS) 或自动管道补偿 (ATC),可能会增加与高流量鼻管 (HFNC) 相比的再输管风险.
科学领域:
- 临界护理医学 临界护理医学
- 呼吸系统疗法 呼吸系统疗法
- 机械通风机械通风机械通风
背景情况:
- 最佳自发呼吸试验 (SBT) 技术平衡输出成功和重新输入风险仍然不清楚.
- 存在各种SBT方法,需要进行有效性和安全性的比较分析.
研究的目的:
- 为了比较不同自发呼吸试验 (SBT) 技术的有效性和安全性.
- 确定哪些SBT方法可以优化成功的输出管,同时最大限度地减少重新输入管.
主要方法:
- 进行了随机对照试验 (RCT) 的系统审查和网络元分析.
- 搜索了Medline,EMBASE和Cochrane中央注册表,直到2023年2月为临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床
- 提取了关于初始SBT成功,成功的输出管,再输入管和死亡率的数据.
主要成果:
- 分析了40个涉及6716名患者的RCT.
- 与T片相比,压力支持 (PS),PS/ATC,HFNC和ATC SBT的初始成功SBT率增加了.
- 与T片SBT相比,PS,ATC和HFNC的成功输出率更高.
结论:
- 使用压力增强 (PS,ATC,PS/ATC) 的自发呼吸试验 (SBTs) 与T片或CPAP相比,提高了最初的成功率和输出率.
- 虽然PS或ATCSBT可能会增加再输管与HFNC相比,PS与T片并没有显示这种增加的风险.
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