在ICU内长时间的上胃肠内镜中,HFNC氧疗法与COT对比:一个前性,随机化,受控临床研究
Ahmed M Mohamed1, Wessam Z Selima1
1Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
在ICU患者的长期上部胃肠内镜期间,高流量鼻氧疗法显著降低了低氧症. 这种方法比传统的氧气疗法更安全,更好地耐受,用于预防低血量发作.
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
- 胃肠病学 胃肠病学
背景情况:
- 低氧症是长期上部胃肠内镜 (UGE) 深度镇静期间经常出现的并发症.
- 接受长期UGE的重症监护病房 (ICU) 患者有较高的缺血事件风险.
研究的目的:
- 为了比较高流量鼻 (HFNC) 氧疗法与常规鼻氧疗法 (COT) 在预防低氧症方面的疗效.
- 在这个患者群体中评估HFNC氧气治疗的安全性和耐受性.
主要方法:
- 一项随机对照试验,涉及70名ICU患者 (ASA I-III) 在深度镇静下进行长时间的UGE (>15分钟).
- 患者被随机分配给接受HFNC或COT.
- 主要结局是发生中度低血量发作 (SpO2 <90%).
主要成果:
- 低血发作的发生率在HFNC组 (5.7%轻度低血) 与COT组相比显著较低 (51.4%的总低血,包括17.1%的中度和2.9%的严重).
- 在HFNC组中没有患者出现SPO2<90%,而在COT组中有20.0%.
- 临床显著的低氧症发生在COT组的9名患者中,而在HFNC组没有患者 (p = 0.001).
结论:
- 在高风险的ICU患者中,HFNC氧疗是一种安全且耐受良好的COT替代品,用于预防长期UGE期间的低氧化.
- 在这种情况下,与COT相比,HFNC疗法显著降低了缺血性发作的发生率.
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