临界病患者的低与高周边氧和定向氧疗法:一个多中心随机对照试验
Xiaobo Yang1, Xuehui Gao1, Xiang Zheng2
1Department of Critical Care Medicine Union Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan China.
MedComm
|February 19, 2025
概括
在重症患者中,低周围氧和 (SpO2) 向氧疗法并没有降低28天死亡率. 这项研究发现,低和高SpO2组之间的死亡率或器官支持无天没有显著差异.
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
- 临床试验 临床试验
背景情况:
- 氧气治疗是管理重症患者的基石.
- 对于周边氧和 (SpO2) 的最佳目标仍在争论中.
- 之前的研究对SPO2目标和患者的治疗结果产生了相互矛盾的结果.
研究的目的:
- 调查氧疗中的低SpO2目标 (90% - 95%) 与高SpO2目标 (≥96%) 相比,是否会降低严重病情的成年人的死亡率.
- 评估不同SPO2目标对二次结果的影响,包括无呼吸器和无置换疗法 (RRT) 的日子.
主要方法:
- 一项随机对照试验,涉及中国11个重症监护病房的成年重症患者.
- 患者被分配到低SpO2 (90%-95%) 或高SpO2 (≥96%) 的组.
- 主要结局是28天全因死亡率;次要结局包括14天的无呼吸器和无RRT时间.
主要成果:
- 总共有1706名患者被纳入 (857名在低SpO2组,849名在高SpO2组).
- 在低SpO2组 (20.1%) 和高SpO2组 (22.7%;p=0.180) 之间,28天全因死亡率没有显著差异.
- 两组之间14天无呼吸器时间或无RRT时间没有显著差异.
结论:
- 针对重症患者的氧气治疗以低SpO2范围 (90% - 95%) 为目标,不会降低28天死亡率.
- 低SPO2导向氧疗没有改善关键的二次结果,如无呼吸器或无RRT时间.
- 目前的证据不支持使用较低的SpO2目标来改善这一患者群体的结果.
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