急性脑损伤患者的通风实践和与结果的关联:VENTIBRAIN多中心观察性研究
Chiara Robba1,2, Daniele Giardiello3, Chiara Almondo4
1Department of Surgical Science and Integrated Diagnostic, University of Genova, Genoa, Italy. kiarobba@gmail.com.
Intensive care medicine
|February 24, 2025
概括
急性脑损伤 (ABI) 患者的机械通风设置存在很大差异. 特定的呼吸器参数,如平原压力,与ICU和6个月死亡率的增加有关,但与神经结果无关.
科学领域:
- 关键护理医学 关键护理医学
- 神经学 神经学
- 呼吸系统医学 呼吸系统医学
背景情况:
- 对急性脑损伤 (ABI) 患者的机械通风实践没有标准化.
- 了解当前的呼吸机设置及其影响对于改善患者的治疗结果至关重要.
研究的目的:
- 描述在重症监护室 (ICU) 用于ABI患者的呼吸机设置.
- 评估这些呼吸器设置与临床结果之间的关联,包括死亡率和神经功能.
主要方法:
- 这是一项国际,前性,多中心的观察性研究,涉及26个国家的74个ICU.
- 包括需要侵入性机械通风的ABI成年患者.
- 在第一周和第10天和第14天,每天记录呼吸器设置;重症监护室和6个月死亡率和神经结果被评估.
主要成果:
- 分析了2095名患有ABI的患者,平均平原压力为15cmH2O,潮体积/预测体重为6.5mL/Kg.
- 观察到呼吸机实践在国际上存在显著差异.
- 更高的平原压力与ICU死亡率的增加密切相关 (HR 1.50). 呼吸器设置与6个月死亡率有着一致的关联,但与神经结果的关联不太清楚.
结论:
- 在ABI患者中,保护性通风策略是常见的,但国际上存在显著的差异.
- 在ICU停留期间的呼吸器设置与ICU和6个月死亡率的增加有关.
- 呼吸器设置与不良的神经结果之间没有明确的关联.
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