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支气管炎:在重症监护机构高风险婴儿的基于证据的管理
Ruth Walsh1, Liam Costello2, Alexandria DiCosimo2
1Discipline of Paediatrics, School of Medicine, Trinity College Dublin, the University of Dublin, College Green, Dublin, 2, Ireland. walshr21@tcd.ie.
Pediatric research
|June 20, 2024
概括
婴儿严重支气管炎的治疗通常不包括高风险病例. 需要更多的研究来了解在儿科重症监护病房 (PICU) 中对这些脆弱婴儿的有效治疗方法.
科学领域:
- 儿科重症监护室的儿童重症监护室
- 新生儿医学 新生儿医学
- 呼吸系统医学 呼吸系统医学
背景情况:
- 严重的支气管炎是婴儿常见的呼吸系统疾病.
- 儿科重症监护室 (PICU) 的管理策略需要进一步调查,特别是对于高危婴儿.
- 目前关于在PICU设置中管理严重支气管炎的基于证据的知识是有限的.
研究的目的:
- 在 PICU 中系统地审查婴儿严重支气管炎的管理.
- 专注于确定严重支气管炎的高风险婴儿的证据差距.
- 为这个患者群体提供未来研究和临床实践的信息.
主要方法:
- 系统文献审查遵循系统审查和元分析协议 (PRISMA-P) 的首选报告项目.
- 搜索了Embase,PubMed和Medline数据库,查找24个月以下婴儿肺炎的PICU治疗研究.
- 包括具有证据I,II和III级的研究.
主要成果:
- 26项研究符合来自455篇审查论文的纳入标准.
- 19项研究重点关注呼吸干预 (例如,正气道压力,氧气输送).
- 7项研究检查了其他疗法 (例如,德克萨米他,Heliox,利尿剂);20项研究排除了高风险婴儿. 对于Heliox,预防性德克萨米他,蛋白质补充剂和利尿剂,注意到了有利的结果.
结论:
- 支气管炎管理的临床试验经常排除高风险婴儿.
- 需要创新的研究设计,以改善高风险婴儿的获取.
- 随机对照试验对于在PICU环境中为高风险婴儿建立有效的支气管炎管理策略至关重要.
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