术后呼吸呼吸器对术后缺氧和抽动心脏手术后肺部并发症 (E-SIGHT) 的影响:随机对照试验的研究方案
Zhichang Wang1, Qiyu Cheng1, Shenglun Huang1
1Jiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, 210009, China.
Trials
|September 5, 2024
概括
这项研究调查了机械通风期间的叹息呼吸,以减少心脏手术后的低氧化和肺部并发症. E-SIGHT试验将评估这种新的方法,以改善患者的治疗结果.
科学领域:
- 麻醉学和重症监护医学
- 呼吸系统生理学 呼吸系统生理学
- 心胸外科手术 心胸外科手术
背景情况:
- 手术后的低氧化和肺部并发症在抽血心脏手术后很常见,通常与肺部脱氧症有关.
- 表面活性剂功能障碍之前的 atelectasis,和叹息呼吸是表面活性剂分泌的强有力的刺激剂.
- 将叹息呼吸添加到肺保护性通风中,以减少这些并发症的有效性尚未得到充分证实.
研究的目的:
- 评估术后呼吸呼吸器对手术后缺氧和肺部并发症的影响,在接受心脏手术的患者中.
- 评估一种旨在减轻与传统肺部保护性通风相关风险的新型通风策略.
- 为未来更大的试验提供数据,调查 sigh通风的好处.
主要方法:
- E-SIGHT试验是一个单中心,双臂随机对照试验,涉及192名患者.
- 实验小组每6分钟接受常规的肺保护通风加上叹息呼吸 (35cmH2O或BMI>35kg/m2的40cmH2O).
- 对照组接受常规的肺保护通风,没有预先计划的招募动作;肺保护通风包括基于ARDSnet表的低潮量和PEEP.
主要成果:
- 主要终点:在输出管后的最初一小时内,时间加权的平均SpO2/FiO2比率.
- 二级终点:手术后肺部并发症 (PPC) 的严重程度,通过手术后的第7天进行评估.
- 这项研究已在clinicaltrials.gov (NCT06248320) 注册,最后更新时间为2024年2月26日.
结论:
- E-SIGHT试验是第一个随机对照试验,用于评估在心脏外科手术中的术后呼吸呼吸.
- 这项试验将引入和评估一种新的方法来减少低氧化和PPCs.
- 这些发现将为未来的研究提供信息,以了解呼吸通风在改善术后肺部结果中的作用.
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