5岁以下患者感染性急性呼吸衰竭:一项追溯性队列研究
Mahmoud Rifai1, Jean Bergounioux2, Nelly Sleiman2
1PICU, Hopital Raymond-Poincare, Garches, France mahmoud.rifai@hotmail.fr.
BMJ paediatrics open
|September 25, 2024
概括
在5岁以下的儿童中,急性下呼吸道感染是死亡的主要原因. 这项研究发现,非侵入性通风 (NIV) 和氧气治疗是儿童重症监护室 (PICU) 管理这些严重病例的关键.
科学领域:
- 儿科 儿科 儿科
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
背景情况:
- 急性下呼吸道感染 (ALRI) 是5岁以下儿童死亡的主要原因之一.
- 对ALRI的诊断和治疗存在重大挑战.
- 这项研究侧重于幼儿重症监护病房 (PICU) 的幼儿感染性急性呼吸衰竭.
研究的目的:
- 描述因病毒或细菌感染而导致的感染性急性呼吸衰竭的5岁以下儿童的特征.
- 分析这些儿童在PICU中的管理和结果.
- 根据年龄 (<= 6个月与> 6个月) 和成像发现 (气泡泡凝结存在/不存在) 来比较患者的特征和治疗方法.
主要方法:
- 在伊利德法兰西地区的两个PICU进行了回顾性研究.
- 包括2017年1月至2021年12月期间住院的5岁以下儿童,患有急性呼吸衰竭复杂的呼吸道感染.
- 收集有关患者特征,PICU管理和结果的数据.
主要成果:
- 包括707名患者,平均年龄为3个月.
- 大多数患者需要氧气治疗 (34% FiO2) 和非侵入性通风 (NIV) (63%在入院时,>70%在住院期间).
- 在近90%的病例中检测到呼吸道病毒,RSV是最常见的;细菌病原体如*Streptococcus pneumoniae*也很常见. 较年轻的儿童 (<6个月) 需要更多的NIV,并且有较少的气囊凝结.
结论:
- 在PICU中治疗严重的ALRI依赖于NIV,氧疗法 (<40%FiO2) 和抗生素.
- 调查结果与澳大利亚和巴西报告的结果相似.
- 实施NIV培训和设备可能会降低儿童因下呼吸道感染的全球死亡率.
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