儿科关键性喘的协议和途径:系统性审查和元分析
Danielle K Maue1, L Denise Willis2,3, Jesslyn Lenox4
1Division of Pediatric Critical Care Medicine, Department of Pediatrics, Cincinnati Children's Hospital, Cincinnati, Ohio, USA.
Respiratory care
|July 11, 2025
概括
儿科喘治疗方案缩短了住院和儿科重症监护室 (PICU) 的时间. 虽然这些协议减少了升级呼吸支的需要,但它们不会影响输管率或非侵入性呼吸支 (NRS) 的使用.
科学领域:
- 儿科重症监护医学 儿科重症监护医学
- 呼吸系统医学 呼吸系统医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 儿科关键性喘是急诊室访问和住院的常见原因.
- 临床途径和协议越来越多地用于呼吸护理,以改善患者的治疗结果.
- 进行了一项系统性审查,以评估协议/途径在治疗儿科关键性喘方面的影响.
研究的目的:
- 系统地审查关于临床途径和方案在儿科关键性喘管理中的有效性的证据.
- 评估这些干预措施对关键临床结果的影响,例如停留时间,输管率和呼吸器支利用率.
主要方法:
- 在没有日期限制的情况下,对MEDLINE,Embase和CINAHL数据库进行了全面的搜索.
- 包括的研究包括随机对照试验,交叉研究,观察研究和质量改进 (QI) 研究.
- 对从23项纳入研究中提取的数据进行了固定效应的元分析.
主要成果:
- 临床途径/协议的使用与住院时间 (平均差异-0.77天) 和PICU停留时间 (平均差异-0.31天) 的显著减少有关.
- 观察到呼吸支升级的发病率降低 (几率比0.59).
- 在输管率 (几率比0.4) 或非侵入性呼吸辅助 (NRS) 使用 (几率比1.12) 中没有发现显著变化.
结论:
- 儿科喘协议与更短的住院和PICU持续时间有关.
- 这些协议有效地减少了升级呼吸支持的需要.
- 目前的证据不支持这些协议对急性儿科喘患者的输管或NRS使用产生重大影响.
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