微吸和呼吸器相关事件之间的关系:对随机对照试验的后期分析
Guillaume Millot1, Hélène Behal2, Emmanuelle Jaillette1
1Médecine Intensive Réanimation, CHU de Lille, F-59000 Lille, France.
这项研究没有发现微吸和通风器相关事件 (VAE) 之间的显著联系. 测量微吸气可能无法帮助预测VAE或评估预防策略.
科学领域:
- 临界护理医学 临界护理医学
- 预防传染病 预防传染病
- 呼吸系统护理 呼吸系统护理
背景情况:
- 呼吸器相关事件 (VAE) 是被直管患者的一个重大问题.
- 口腔大或胃内容的微吸收是VAE的潜在贡献者.
- 微吸的程度和VAE发病率之间的直接关系仍未得到充分研究.
研究的目的:
- 调查大量的微吸 (全球,胃或口腔) 与直管成年患者中VAE发生的相关性.
- 为了确定微志向的定量标记能否预测VAE发展.
主要方法:
- 对多中心BESTCUFF试验的后期分析,该试验涉及成人患者,通风时间超过48小时.
- 在48小时内在气管吸附物中定量测量素和α-amylase.
- 使用国家医疗保健安全网络标准进行VAE识别;根据混因素进行统计调整.
主要成果:
- 分析了261名患者;11.9%的患者出现了VAE.
- 在丰富的全球微吸和VAE (aHR:1.55 [0.46-5.17]) 之间没有发现显著的关联.
- 丰富的胃 (aHR: 1.24 [0.61-2.53]) 或口腔喉微吸 (aHR: 1.07 [0.47-2.42]) 也没有显示出与VAE发生率的显著联系.
结论:
- 丰富的微吸,无论是全球的,胃的还是口腔的,都与VAE的发病率没有显著的关联.
- 目前用于测量微吸的方法可能无法在临床上用于预测直管患者的VAE.
- 可能需要进一步的研究来确定可靠的VAE生物标志物或预测因素.
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