非侵入性正压通风可以降低急性大动脉剖析患者的外科死亡率
Baojuan Liu1, Gen Ye2, Ruirui Wang3
1Department of Emergency Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.
Journal of thoracic disease
|October 24, 2024
概括
非侵入性正压通风 (NIPPV) 是急性大动脉剖析 (AAD) 患者的最佳氧化策略,在急诊室 (ED) 患有低氧症. 早期使用NIPPV可以降低输管率和死亡率,改善患者的治疗结果.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 紧急医疗 紧急医疗
背景情况:
- 低氧症是急性大动脉解剖 (AAD) 患者的常见和关键并发症.
- 在AAD手术前的低氧症与不良的临床结果有关.
- 在急诊室 (ED) 确定最佳的氧化策略对于AAD患者至关重要.
研究的目的:
- 为了确定最有效的氧化治疗AAD患者经历低氧症在ED.
- 为了比较鼻腔管,Venturi口罩和非侵入性正压通风 (NIPPV) 在这个患者队列中的疗效.
主要方法:
- 追溯观察队列研究187名成年AAD患者的低氧症被录入ED.
- 患者被分为三个组:鼻,Venturi口罩和NIPPV.
- 主要结局:ED内死亡率. 二级结局:输内管率,术后死亡率和停留时间.
主要成果:
- 在NIPPV组中,ED输管率是最低的 (2.78%).
- NIPPV与最短的ICU和住院时间以及输管持续时间有关.
- 卡普兰-梅尔分析表明,NIPPV组的3天和5天生存率更高.
结论:
- 在患有低氧血症的AAD患者中早期使用NIPPV有效地减少了手术前输管.
- 尼普普病毒与术后死亡率降低和术后结果改善有关.
- 在ED中,NIPPV代表了对缺血性AAD患者的最佳氧化策略.
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