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在重症患者中以超声引导的皮肤过渡性神经刺激:评估隔膜功能的一种新方法

Mathieu Capdevila¹, Audrey De Jong¹, Fouad Belafia²

¹Department of Anesthesiology and Critical Care Medicine B (DAR B), Saint-Eloi Hospital, University Teaching Hospital of Montpellier, Montpellier, France; INSERM U1046, Montpellier, France.

|October 21, 2024

概括

超声导向的超皮电动神经刺激 (SONOTEPS) 准确地评估了ICU患者的隔膜功能. 这种简单的方法有助于诊断隔膜功能障碍,改善患者的护理.

科学领域:

关键护理医学关键护理医学
肺部病理学肺部病理学
医学超声波医学超声波

背景情况:

隔膜功能障碍在ICU中很普遍,与断奶失败和死亡率有关.
目前的黄金标准诊断 (磁性神经刺激) 是资源密集型的,需要专业知识.
需要可访问的床边工具来评估隔膜功能.

研究的目的:

评估超声波导向的皮肤过渡电动神经刺激 (SONOTEPS) 用于每日床边隔膜功能评估.
为了比较SONOTEPS与已建立的磁性神经刺激方法.

主要方法:

一项随机交叉研究,涉及机械通风的ICU患者.
与磁性神经刺激的SONOTEPS的比较.
主要结局:通过刺激引起的气管压力.

主要成果:

与磁性刺激相比,SONOTEPS没有显著的差异 (斜率0.98,截图-0.03).
对于隔膜功能障碍 (AUC 0.90) 和严重功能障碍 (AUC 0.88) 的高相关性 (R2 = 0.639) 和优异的诊断性能.
性能不受BMI或部导管存在的影响.

结论:

SONOTEPS是一种简单,准确的床头工具,用于评估隔膜功能.
超声导向的皮肤间神经刺激在镇静患者中是有效的.
这种方法有助于在重症监护机构每天监测隔膜功能.

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