预防性非侵入性通风对断奶的影响:通过元分析进行系统性审查
Helder B Duarte1, Ueidson J S Batista2, Paula M Oliveira2
1Residência em Fisioterapia Hospitalar com Ênfase em Terapia Intensiva, Salvador, Brazil; Programa de Pós-Graduação em Medicina e Saúde, Universidade Federal Bahia, Salvador, Brazil.
概括
预防性非侵入性通风 (NIV) 显著降低了再输管,重症监护室 (ICU) 停留时间 (LOS) 和死亡率. 这些发现支持在符合条件的患者中在临床实践中常规使用NIV.
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
- 基于证据的医学基于证据的医学.
背景情况:
- 机械通风对于重症患者至关重要,但也存在风险.
- 再灌管和后灌管呼吸衰竭是严重的并发症.
- 非侵入性通风 (NIV) 是一种替代的支持方法.
研究的目的:
- 评估预防性非侵入性通风 (NIV) 的有效性.
- 评估NIV对重新灌输,呼吸衰竭,停留时间 (LOS) 和死亡率的影响.
- 为NIV在重症监护室 (ICU) 患者管理中的作用提供证据.
主要方法:
- 随机和准随机临床试验的系统审查和元分析.
- 包括有超过48小时的机械呼吸和成功的自发呼吸测试的成年患者.
- 将预防性NIV与标准氧气补充剂进行比较.
主要成果:
- 预防性NIV显著降低了重新灌输率 (OR:0.49;95% CI:0.32,0.74).
- 尼维降低了ICU死亡率 (OR:0.39;95%CI:0.21,0.71) 和医院死亡率 (OR:0.53;95%CI:0.33,0.85). 这两种疗法均有助于降低患病率.
- 在ICU,LOS减少了 (MD: -2.86天;95%CI: -5.47, -0.24),呼吸衰竭也减少了 (OR: 0.28;95%CI: 0.12, 0.67).
结论:
- 预防性NIV有效地减少了重新灌输,ICU LOS和死亡率.
- 这些发现支持在临床实践中常规使用预防性NIV的建议.
- 救援NIV在子组分析中没有显示出结果的显著差异.
更多相关视频
相关概念视频
Mechanical Ventilation III: Noninvasive Ventilation
68
Noninvasive positive-pressure ventilation (NIPPV), continuous positive airway pressure (CPAP), and bilevel positive airway pressure (BiPAP) are essential methods in respiratory care. These ventilation techniques offer unique benefits for patients with various respiratory conditions, providing adequate support without requiring intubation. Let's explore how each method is crucial in improving patient outcomes and enhancing respiratory therapy.
Noninvasive Positive-Pressure Ventilation...
Noninvasive Positive-Pressure Ventilation...
68
Mechanical Ventilation II: Invasive Ventilation
84
Ventilators are essential medical equipment used to aid patients with respiratory difficulties. Their primary function is to assist or replace spontaneous breathing by providing mechanical ventilation. There are two general classes of mechanical ventilators: negative-pressure and positive-pressure ventilators.
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...
84
Mechanical Ventilation I: Indication and Settings
134
Mechanical ventilation is a life-saving technique for managing acute respiratory failure and other respiratory complications. The process involves using a machine known as a ventilator to supply oxygen to the lungs and assist in removing carbon dioxide. It serves as a bridge to long-term mechanical ventilation or a temporary measure until ventilatory support is discontinued. The ventilator can maintain this function for a prolonged period, providing critical support for patients until they can...
134
Ventilatory Modes
48
Mechanical ventilators are life-saving devices that support or replace spontaneous breathing. They deliver breaths to patients through varying methods known as ventilator modes. Understanding these modes is critical for healthcare providers managing patients with respiratory failure.
There are three ventilatory modes: full support, partial support, and spontaneous. These are described below.
Full Support Modes
Full support modes include controlled mechanical ventilation, continuous mandatory...
There are three ventilatory modes: full support, partial support, and spontaneous. These are described below.
Full Support Modes
Full support modes include controlled mechanical ventilation, continuous mandatory...
48
Factors Affecting Pulmonary Ventilation
1.0K
Besides the pressure difference between the external environment and the lungs, the airflow rate and ease of pulmonary ventilation are also influenced by three other factors: surface tension of the fluid in the alveoli, compliance of the lungs, and airway resistance.
Alveolar Surface Tension
The alveolar fluid lines the luminal surface of the alveoli and exerts a force called surface tension. This force is caused by the polar water molecules in the liquid being more strongly attracted to each...
Alveolar Surface Tension
The alveolar fluid lines the luminal surface of the alveoli and exerts a force called surface tension. This force is caused by the polar water molecules in the liquid being more strongly attracted to each...
1.0K
Endotracheal Tube Extubation
306
Endotracheal tube extubation is a critical procedure in weaning patients from mechanical ventilation. It involves physically removing the oral or nasal endotracheal (ET) tube, marking the final step in liberating a patient from ventilatory support.
Procedure
Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals....
Procedure
Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals....
306


