在头部和部手术中使用机械通风的断奶患者中使用高流量鼻:回顾性研究
Vincenzo Pota1, Francesco Coppolino1, Luca Gregorio Giaccari2
1Department of Women, Child, General and Specialistic Surgery, University of Campania "L. Vanvitelli", 80138 Naples, Italy.
高流量鼻 (HFNC) 治疗有效地支持头部和部手术后的患者,显著减少低氧化和消除重新灌输. 这项研究强调HFNC是高风险手术患者的安全选择.
科学领域:
- 呼吸系统医学
- 外科瘤学
- 危急护理医学
背景情况:
- 在手术后出现呼吸道并发症的风险很高.
- 传统的氧气治疗 (COT) 和非侵入性呼吸 (NIV) 在这个患者群体中存在局限性.
- 高流量鼻 (HFNC) 治疗提供了潜在的好处,包括改善湿度,舒适度和氧化.
研究的目的:
- 评估使用HFNC治疗的头重建手术患者的术后低氧症的发生率.
- 评估二次结果,包括重新灌输率和患者对HFNC的遵守.
- 确定HFNC的安全性和有效性作为手术后的呼吸辅助策略.
主要方法:
- 50名头部和部瘤手术后的成年患者的回顾性单中心研究.
- 所有患者在抽管后立即接受HFNC.
- 低氧症定义为PaO2/ FiO2 (P/ F) 比率< 300 mm Hg;数据采集于1,6,12和24小时.
主要成果:
- 只有4% (2/ 50) 的患者出现低氧症,P/ F比超过250.
- 在研究期间,没有患者需要重新灌输.
- 呼吸速率-氧化指数 (ROX) 稳步改善,HFNC耐受性很好,不引起任何不适.
结论:
- 在头部和部手术后的术后使用HFNC与低氧化症的发病率低,并且没有再输液.
- 对于这种高风险的手术患者来说,HFNC似乎是一种安全有效的呼吸辅助策略.
- 建议进行进一步的前性研究,以证实这些在减少低氧化和预防再灌输方面的益处.
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