如何预防抽后呼吸衰竭
Gonzalo Hernández1,2,3,4, Nicholas S Hill5
1Toledo University Hospital, Toledo.
Current opinion in critical care
|November 11, 2024
概括
选择正确的喷后呼吸器支是关键. 高流量鼻适合低风险患者,而非侵入性通风最适合高风险,肥胖或高风险的人.
科学领域:
- 关键护理医学 关键护理医学
- 呼吸系统疗法 呼吸系统疗法
- 肺部病理学 肺部病理学
背景情况:
- 输出管后呼吸支策略正在发展,在设备选择,时间和设置方面提出了挑战,以尽量减少输出管失败.
- 最佳的患者分层和量身定制的治疗方法对于成功从机械通风中断奶至关重要.
研究的目的:
- 审查当前关于 postextubation 呼吸支的证据.
- 为了帮助临床决策在床边,以尽量减少输出失败.
主要方法:
- 对现有临床证据的系统审查.
- 分析患者子组及其对不同疗法的反应.
主要成果:
- 高流量鼻腔管 (HFNC) 对低风险患者有效.
- 对于高风险患者 (肥胖患者,超气后自发呼吸试验) 建议进行非侵入性通风 (NIV).
- 需要针对中等风险患者做出量身定制的决定,考虑各种临床因素.
结论:
- 静脉注射后呼吸支计划需要进行风险评估,并考虑有利于NIV的临床条件.
- 输出管的时间可以优化,但必须避免延迟必要的再输入管.
- 根据患者特定的因素和风险分层,有必要增加对术后NIV的使用率.
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