在慢性呼吸衰竭患者中,NIV转换为CPAP的现实生活评估. 一个病例控制研究研究
Louise Mathieu1, Claudio Rabec1, Guillaume Beltramo2
1Department of Respiratory Diseases and Intensive Care, Reference Center for Adult Rare Pulmonary Diseases, University Hospital of Dijon-Bourgogne, Dijon, France; University of Bourgogne Franche-Comté, Dijon, France.
将慢性呼吸衰竭和阻塞性睡眠呼吸暂停的稳定患者从非侵入性通风 (NIV) 转换为持续正气道压力 (CPAP) 是可行的. 在NIV期间的低压支是成功过渡到CPAP的关键.
科学领域:
- 呼吸系统医学 呼吸系统医学
- 睡眠医学 睡眠医学
- 关键的护理关键的护理
背景情况:
- 非侵入性通风 (NIV) 是超性慢性呼吸衰竭 (CRF) 的标准.
- 阻塞性睡眠呼吸暂停综合征 (OSA) 经常导致CRF患者的低通风.
- 持续正气道压力 (CPAP) 可以改善COPD和肥胖患者的高头,类似于NIV.
研究的目的:
- 在长期通风队列中,描述从NIV切换到CPAP的患者.
- 为了确定与成功的NIV到CPAP切换相关的因素.
主要方法:
- 一项病例控制研究比较了88名从NIV转换为CPAP的患者和266名对照.
- 一个标准化的协议包括NIV戒断后的多睡眠学.
- 已确认严重的OSA开始CPAP试验,并对低通风进行随访.
主要成果:
- 64%的患者被安全地切换到长期CPAP.
- 与切换概率相关的因素包括年龄较大,BMI较高,COPD或肥胖病因,急性恶化开始,较低的压力支,较低的基线PaCO2和较低的遵守.
- 在使用CPAP出院的患者中,即使调整了BMI和年龄,只有压力支水平与切换结果有显著的关联.
结论:
- 在现实条件下,在稳定的肥胖和COPD患者中,可以从NIV切换到CPAP.
- 在NIV期间的压力支水平是成功过渡到CPAP的关键因素.
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