术周氧疗法:系统性审查和元分析的概述
Adel Elfeky1, Yen-Fu Chen1, Amy Grove1
1Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK.
British journal of anaesthesia
|June 7, 2025
概括
高水平的外科手术期间氧气可能会略微减少手术部位的感染,但会增加脱氧的风险. 证据不支持常规高氧使用,有利于术后的非侵入性通风或高流量鼻氧,尽管确定性很低.
科学领域:
- 麻醉学 麻醉学
- 关键护理医学 关键护理医学
- 外科手术的结果
背景情况:
- 术周氧疗法是常见的,但其临床影响仍在争论中.
- 目前的氧气管理实践因证据不一致而有所不同.
- 这项研究提供了一个关于外科手术期间氧气治疗有效性的全面概述.
研究的目的:
- 评估不同的外科手术期间氧气治疗策略的有效性.
- 综合有关氧气对手术部位感染和死亡率的影响的证据.
- 评估各种氧化方案的证据确定性.
主要方法:
- 对外科手术期间氧气策略的多个数据库进行系统审查.
- 由两个独立的审查员提取数据,重点是手术部位感染和死亡率.
- 更新了定审查的元分析和子组分析,用GRADE和试验顺序分析评估证据确定性.
主要成果:
- 吸入氧气 (FiO2) 的高分量可能会略微减少SSI,但会增加脱氧症的风险;证据非常不确定.
- 高的FiO2在死亡率上几乎没有差异 (低确定性证据).
- 手术后的非侵入性通风 (NIV) 和高流量鼻氧 (HFNO) 可能会减少肺部不良事件,但证据确定性低至非常低.
结论:
- 没有强有力的证据支持常规高启发氧减少SSI或改善结果.
- 不能排除具有高FiO2的潜在的小SSI降低;需要进一步研究.
- 手术后的NIV和HFNO比传统的氧气疗法更有前途,但证据的低确定性限制了信心.
更多相关视频
04:10Author Spotlight: Exploring Venous Waveforms for Non-Invasive Respiratory Monitoring in Pigs
Published on: March 8, 2024
1.8K
14:28Non-Invasive Monitoring of Microvascular Oxygenation and Reactive Hyperemia using Hybrid, Near-Infrared Diffuse Optical Spectroscopy for Critical Care
Published on: May 10, 2024
2.1K
相关概念视频
01:23Physiological Control of Respiration
5.0K
Introduction
Breathing, a seemingly passive process, is regulated by the respiratory center in the brainstem. This center coordinates the involuntary control of respirations, which means it occurs without conscious effort, ensuring a smooth and uninterrupted pattern.
Regulation of Ventilation
The body maintains ventilation by monitoring levels of carbon dioxide (CO2), oxygen (O2), and hydrogen ion concentration (pH) in the arterial blood. Among these factors, the level of CO2 plays a crucial...
Breathing, a seemingly passive process, is regulated by the respiratory center in the brainstem. This center coordinates the involuntary control of respirations, which means it occurs without conscious effort, ensuring a smooth and uninterrupted pattern.
Regulation of Ventilation
The body maintains ventilation by monitoring levels of carbon dioxide (CO2), oxygen (O2), and hydrogen ion concentration (pH) in the arterial blood. Among these factors, the level of CO2 plays a crucial...
5.0K
01:19Respiratory Assessment: Purpose and Indications
2.1K
Respiratory assessment is a cornerstone of nursing assessments, crucial for the early detection of patient deterioration. This evaluation transcends routine procedures, representing a critical skill nurses must master to ensure optimal patient care.
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...
2.1K
01:24General Anesthesia: Overview
1.1K
Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
1.1K
01:16Treatment for Pulmonary Arterial Hypertension: Oxygen Therapy for Respiratory Failure
817
Oxygen therapy has emerged as a significant tool in enhancing the quality of life for patients suffering from pulmonary arterial hypertension (PAH). While this therapy has principally been studied on patients with significant hypoxemia, this therapeutic approach helps prevent potential organ damage and can be administered in the comfort of one's home.
Oxygen therapy is vital in increasing and maintaining blood oxygen levels in PAH patients. As a result, it aids in reducing fatigue,...
Oxygen therapy is vital in increasing and maintaining blood oxygen levels in PAH patients. As a result, it aids in reducing fatigue,...
817
01:16Oxygen Delivering System II: Venturi Mask and Transtracheal Oxygen
3.7K
Oxygen therapy is a pivotal aspect of medical care, particularly for patients with respiratory ailments. Two prominent oxygen-delivering systems include the Venturi mask and the transtracheal oxygen catheter.
Venturi Mask
The Venturi mask, named after the Venturi effect, is designed to deliver precise oxygen concentrations. It consists of a large tube with an oxygen inlet that narrows down, causing a pressure drop that pulls air in through adjustable side ports. The mask is a lightweight,...
Venturi Mask
The Venturi mask, named after the Venturi effect, is designed to deliver precise oxygen concentrations. It consists of a large tube with an oxygen inlet that narrows down, causing a pressure drop that pulls air in through adjustable side ports. The mask is a lightweight,...
3.7K
01:30Administering Oxygen by Mask
4.4K
Administering Oxygen by Mask
Administering oxygen by mask is a common nursing intervention that provides supplemental oxygen to patients with respiratory distress or chronic lung conditions. This procedure involves delivering oxygen at a specified rate through a face mask connected to an oxygen source.
Equipment
The equipment necessary for this procedure includes:
Administering oxygen by mask is a common nursing intervention that provides supplemental oxygen to patients with respiratory distress or chronic lung conditions. This procedure involves delivering oxygen at a specified rate through a face mask connected to an oxygen source.
Equipment
The equipment necessary for this procedure includes:
4.4K