儿科输出管失败和非侵入性呼吸辅助使用的当代趋势
Jeremy M Loberger1, Mitchell Moore2, Matthew Scanlon3
1Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL.
Chest
|August 16, 2025
概括
在10年内,儿童的输出管后非侵入性呼吸支持几乎翻了一番,使输出管失败 (EF) 风险降低了10%. 虽然EF与发病率有关,但它不会增加死亡率.
科学领域:
- 儿科重症监护医学 儿科重症监护医学
- 呼吸系统支持策略 呼吸系统支持策略
- 机械通风的结果
背景情况:
- 长时间的机械通风在儿童中增加了发病和死亡的风险.
- 及时的输出需要平衡输出失败 (EF) 与长时间的非侵入性支持.
- 了解EF和呼吸支持的趋势对于儿科重症监护至关重要.
研究的目的:
- 调查EF风险因素的变化,率,以及从2013年到2022年抽出口腔后的非侵入性呼吸辅助实践.
- 评估与这些变化相关的以患者为中心的结果.
- 为了在十年内确定儿科输出管管理的趋势.
主要方法:
- 对132,712例儿童 (年龄<19岁) 进行了回顾性横截面研究,需要侵入性机械通风≥24小时.
- 从虚拟儿科重症监护,LLC质量改进数据库 (2013-2022) 分析的数据.
- 后勤回归用于确定EF风险因素和评估结果关联.
主要成果:
- 总体EF率为8.5%;术后的非侵入性支持使用几乎翻了一番 (20.9%至39.9%).
- EF率略有下降 (≤7天:12.3%至11.0%). EF率略有下降 (≤7天:12.3%至11.0%).
- 年龄较小,特定的诊断 (脏,呼吸道,心脏) 和更长的输出前通风与EF概率的增加有关. EF与更长的ICU和住院时间相关,但不与死亡率相关.
结论:
- 输出管后的非侵入性支持显著增加,与EF的适度减少相关.
- 高风险儿科患者群体可能会受益,但低风险群体的潜在过度使用需要考虑.
- 输出失败与显著的发病率有关,但未增加儿科患者的死亡率.
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