在成年呼吸困扰综合征中神经肌肉阻塞
Karen E A Burns1, Sheila Nainan Myatra2
1Department of Critical Care, Unity Health Toronto - St. Michael's Hospital, University of Toronto, 30 Bond Street, Office 4-045 Donnelly Wing, Toronto, Ontario M5B 1W8, Canada.
Clinics in chest medicine
|October 23, 2024
概括
神经肌肉阻断剂 (NMBAs) 可能有助于严重急性呼吸困扰综合征 (ARDS) 患者深度镇静或呼吸器失调. 根据目前的证据,尽可能将NMBA使用限制在48小时内.
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
- 药理学 药理学是指药理学的学科.
背景情况:
- 对急性呼吸困扰综合征 (ARDS) 的神经肌肉阻断剂 (NMBA) 的临床实践指南提出了不一致的结论.
- 在ARDS中使用NMBA需要仔细考虑,因为潜在的好处和风险.
研究的目的:
- 为严重ARDS患者提供一种明智的NMBA输液方法.
- 在特定的ARDS患者群体中指导NMBA治疗的适当使用和持续时间.
主要方法:
- 关于在严重ARDS中使用NMBA的现有证据的审查.
- 分析患者镇静水平和与NMBA管理有关的呼吸器异步.
主要成果:
- 在深度镇静的早期严重ARDS患者中,NMBA输液可能是有益的.
- 考虑在轻度镇静的患者中使用NMBA,有显著的呼吸器失调,即使在呼吸器和镇静调整后也是如此.
- 目前的证据表明,在可行的情况下,将NMBA持续时间限制在48小时.
结论:
- 建议在ARDS中选择性地使用NMBA.
- 根据镇静深度和呼吸器同步来定制NMBA疗法.
- 在可能的情况下,在ARDS中坚持NMBA输液的最长48小时持续时间.
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