患有间歇性肺部疾病和急性呼吸衰竭而没有头部增大症的成年人:什么时候应该使用高流量鼻氧?
Laura White1,2, Maryam Ellam3, Rebecca Hickman3
1Lancaster Medical School, Lancaster University, Lancaster, England, UK laurajanewhite@doctors.org.uk.
高流量鼻氧 (HFNO) 没有显著改善急性呼吸衰竭 (ARF) 间歇性肺病 (ILD) 患者的死亡率. 虽然HFNO可能会提供一些症状缓解,但死亡率仍然很高,需要对患者和家庭进行仔细的讨论.
科学领域:
- 肺部病理学 肺部病理学
- 关键护理医学 关键护理医学
- 呼吸系统医学 呼吸系统医学
背景情况:
- 间歇性肺部疾病 (ILD) 是异质的肺部疾病.
- 患有ILD的患者经常经历呼吸失补偿,导致急性呼吸衰竭 (ARF).
- 高流鼻氧 (HFNO) 越来越多地用于ARF.
研究的目的:
- 评估HFNO是否优于常规氧气疗法 (COT) 在成年人患有ILD和ARF (没有高头) 中.
- 评估HFNO与COT对症状和全因死亡率的影响.
主要方法:
- 对两项比较HFNO和COT在ARF的ILD患者中的研究进行系统审查.
- 从1975年到2025年6月,在Medline,EMBASE和Cochrane图书馆进行了搜索.
- 提取的研究信息,人口统计,结果和弱点.
主要成果:
- 两项系统性审查都没有发现与COT相比,HFNO的死亡率有统计学上显著的改善.
- HFNO的中位生存时间为21天,与COT的133天相比 (p=0.1323).
- 住院患者的死亡率从HFNO的26.5%到59.1%不等;一项研究指出了数值症状的改善.
结论:
- 有限的证据表明,HFNO不会改善ARF的ILD患者的死亡结果.
- 在这个人群中,HFNO可能为症状管理提供好处.
- 高死亡率强调了需要仔细讨论关于在ARF中使用HFNO的必要性.
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