比例辅助通风,以尽量减少机械通风的持续时间
Karen J Bosma1,2,3, Karen E A Burns4,5, Claudio M Martin1,2,3
1Critical Care Western, Department of Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Canada.
The New England journal of medicine
|June 13, 2025
概括
负载调节增益因子 (PAV+) 的比例辅助通风与重症患者的压力支通风 (PSV) 相比,并没有显著缩短机械通风释放的时间. 这两种通风策略在无呼吸器日和死亡率方面显示出相似的结果.
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
- 机械通风机械通风机械通风
背景情况:
- 对于重症患者来说,加速从机械通风中释放至关重要,以减少并发症和改善结果.
- 带有负载调节增益因子 (PAV+) 的比例辅助通风与压力支通风 (PSV) 在机械通风中断奶的比较有效性仍然不清楚.
研究的目的:
- 为了比较PAV+与PSV在减少成年患者机械通风成功释放的时间方面的疗效.
- 评估二次结果,包括无呼吸器日,再输管,气管切除术和90天死亡率.
主要方法:
- 一项国际临床试验随机选择了573名成年患者,接受机械通风至少24小时,接受PAV+或PSV.
- 主要结局是随机化到成功摆脱机械通风的时间.
- PAV+的目标是正常的呼吸,而PSV的目标是正常的呼吸速率和潮体积.
主要成果:
- 从机械通风释放的中位时间在两组之间是相似的:PAV+ 7.3天,PSV 6.8天 (P=0.58).
- 二次性结局,包括无呼吸器日,再输管,气管切除术和90天死亡率,在PAV+和PSV组之间也是可比的.
- 严重的不良事件发生在PAV+组的10.8%,PSV组的9.8%中.
结论:
- 与压力支通风 (PSV) 相比,带有负载调节增益因子 (PAV+) 的比例辅助通风并没有显著减少从机械通风中解放的时间.
- 这两种通风模式在这种重症患者群体中表现出相似的临床结果和安全概况.
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