高风险儿童的非侵入性通风与高流量鼻:一个非劣势随机临床试验
Anil Sachdev1, Mukul Panday1, Sapna Jain1
1Drs. Sachdev, Panday, Jain, Sawhney, Neeraj Gupta, Dhiren Gupta, and Suresh Gupta are affiliated with Department of Pediatrics, Institute of Child Health, Sir Ganga Ram Hospital, Rajinder Nagar, India.
Respiratory care
|November 13, 2025
概括
在高风险儿童中,加热湿化高流量鼻腔管 (HFNC) 与非侵入性通风 (NIV) 一样有效地预防重新输管. 使用HFNC与较低的镇静剂剂量和较短的PICU停留时间有关.
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 呼吸系统支持
- 机械通风 断奶 断奶 机械通风
背景情况:
- 非侵入性通风 (NIV) 和加热湿化高流量鼻腔管 (HFNC) 在高风险儿科患者中预防输出失败的比较疗效尚不清楚.
- 儿科重症监护室 (PICU) 的输出失败与增加的发病率和死亡率有关.
研究的目的:
- 为了比较接受HFNC或NIV的高风险儿童在输出管后48小时内重新输入管率.
- 评估二次结果,包括镇静剂需求和PICU停留时间.
主要方法:
- 一个开放标签,并行,非劣势随机试验,涉及高风险儿科患者 (1个月至18岁) 输管超过48小时.
- 患者被随机分配,在输出管之前立即接受HFNC或NIV,并预先定义了呼吸辅助设置的协议.
- 关键结局包括在48小时内重新输液,血液动力稳定,呼吸工作和氧和 (SpO2).
主要成果:
- 在HFNC (11.9%) 和NIV (10.5%) 组 (P = .74) 之间没有观察到重灌率的显著差异.
- 接受HFNC治疗的患者与NIV治疗的患者相比,需要显著降低德克斯梅德托米丁的剂量 (P < .001).
- 与NIV组 (4天) 相比,HFNC组 (3天) 的患者在术后PICU停留时间的中位数显著更短 (P = .02).
结论:
- 加热加湿高流量鼻腔管 (HFNC) 与非侵入性通风 (NIV) 相比,在管切除后的高风险儿童中提供呼吸支持.
- 在降低镇静剂需求和缩短PICU停留时间方面,HFNC可能会提供优势.
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