在早产婴儿的非侵入性通风中,RAM管与短双鼻管相比:更新的系统性审查和元分析
Jogender Kumar1, Jitendra Meena2, Pradeep Debata3
1Neonatal Unit, Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India.
Indian journal of pediatrics
|July 31, 2024
概括
拉姆管和短双鼻 (SBPs) 在早产婴儿的呼吸支方面表现出类似的疗效. 然而,与SBP相比,RAM管的使用可能会减少鼻损伤,尽管证据确定性很低.
科学领域:
- 新生儿医学 新生儿医学
- 呼吸系统护理 呼吸系统护理
- 医疗器械技术 医疗器械技术
背景情况:
- 过早出生的婴儿往往需要呼吸支持,如鼻腔连续正气道压力 (nCPAP) 或鼻间歇性正压通风 (NIPPV).
- 鼻腔接口,如RAM管和短双鼻 (SBPs),对于提供这种支持至关重要.
- 优化鼻腔接口选择对于有效性至关重要,并最大限度地减少鼻腔损伤等并发症.
研究的目的:
- 为了比较RAM管与SBP在早产婴儿中的有效性和安全性.
- 评估包括nCPAP/NIPPV失败,鼻损伤,机械通风,空气泄漏和死亡率在内的结果.
主要方法:
- 系统地搜索电子数据库和试验登记册,直到2024年3月.
- 包括五项随机对照试验 (RCT),涉及825名早产婴儿.
- 随机效应元分析,以比较nCPAP/NIPPV输送的RAM管与SBP.
主要成果:
- 在nCPAP/NIPPV失效或需要RAM管和SBP之间进行侵入性机械通风时没有显著差异 (确定性低至非常低).
- 与SBP相比,RAM管组显示中度至重度鼻损伤的发生率明显较低 (确定性低).
- 在其他临床结果 (如空气泄漏或死亡率) 中没有发现显著差异.
结论:
- 在早产婴儿的呼吸支中,RAM管可能与SBP具有相似的疗效,但关于失败率的证据非常不确定.
- 低确定性证据表明,在这个人群中,使用RAM管可能会减少中度至重度的鼻创伤.
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