连续高频振荡治疗对有意识障碍的机械通风患者肺气化的影响:多中心随机对照试验
Zhengyong Hu1, Xuehua Pu2, Rui Tang3
1Jiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, Department of Rehabilitation Medicine, Zhongda Hospital, Southeast University, Nanjing, Jiangsu, China.
Chest
|September 22, 2025
概括
连续高频振荡 (CHFO) 疗法显著降低了机械通风的有意识障碍的患者的肺动脉. 这种改善的肺气化导致了更好的临床结果,包括更少的呼吸机日和更短的ICU停留时间.
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
- 肺部医学 肺部医学
背景情况:
- 透气症是机械通风患者有意识障碍的常见并发症,通常是由分泌物积累引起的.
- 这可能会延长通风时间和重症监护室 (ICU) 停留时间.
研究的目的:
- 为了调查持续高频振荡 (CHFO) 疗法是否可以改善肺空气和减少因意识受损而需要机械通风的成年人的肺空气.
主要方法:
- 一个多中心,单盲,随机对照试验,涉及80名意识受损的成年患者 (格拉斯哥昏迷表得分≤8) 需要侵入性机械通风.
- 患者被随机分配1:1接受CHFO治疗 (每天3-4次) 或常规护理.
- 主要结局是非空气化肺组织的百分比变化,从基线到第5天通过CT扫描评估.
主要成果:
- 通过CHFO治疗,到第5天,非化肺组织的减少显著增加 (-51.3%),与通常治疗 (-37.6%) 相比 (P = .017).
- 此外,CHFO组的无呼吸器日数增加,临床肺部感染得分降低,ICU停留时间缩短.
- 在CHFO组中没有报告任何重大不良事件.
结论:
- 五天的CHFO治疗有效地减少了机械通风的有意识障碍的患者的非空气化肺组织.
- 在这种患者群体中,CHFO疗法是一个有前途的干预措施,可以改善肺气化和临床结果.
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