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儿童重症监护病房的儿童的通风-断奶协议:随机试验的系统审查
Suzana C Almeida1, Rayany C de Souza2, Ingrid G Azevedo3
1Graduate Program in Physiotherapy, Physical Education and Physiotherapy School, Universidade Federal de Uberlândia, Uberlândia, Brazil.
Pediatric pulmonology
|December 22, 2025
概括
在儿科重症监护病房中实施呼吸机断奶协议可能会缩短侵入性机械通风的持续时间和住院时间. 然而,减少输出管失败或死亡率的证据仍然有限,需要进一步进行高质量的研究.
科学领域:
- 儿科重症监护医学 儿科重症监护医学
- 呼吸系统疗法 呼吸系统疗法
- 基于证据的医学基于证据的医学.
背景情况:
- 机械通风是儿科重症监护室 (PICU) 的关键支持.
- 优化呼吸机断奶对于患者的康复和资源管理至关重要.
- 当前的做法各不相同,需要对标准化协议进行评估.
研究的目的:
- 评估通风机断奶方案在减少侵入性机械通风 (IMV) 持续时间方面的有效性.
- 评估这些协议对儿科重症监护室 (PICU) 和住院时间 (LOS) 的影响.
- 确定对儿科患者输出管失败率和死亡率的影响.
主要方法:
- 进行了随机对照试验的系统审查和元分析.
- 在包括PubMed,EMBASE,CINAHL,Web of Science和Cochrane Central在内的主要数据库中进行了搜索.
- 选择了将断奶协议与在PICU环境中的通常护理进行比较的研究,并评估了偏差风险和证据确定性.
主要成果:
- 分析了7项涉及11,742名患者的试验.
- 断奶协议和自动计算机驱动断奶显著缩短了IMV持续时间 (中等确定性证据).
- 镇静加通风方案在患有呼吸系统疾病的儿童中减少了医院LOS,但在PICU LOS,输出失败或死亡率方面没有发现显著差异.
结论:
- 有限的证据表明,特定的呼吸机断奶协议可以减少儿科患者的IMV持续时间和住院时间.
- 这些协议在预防输出管失败或降低死亡率方面的有效性尚未确定.
- 需要高质量的研究来证实断奶方案的安全性和有效性,因为目前的证据是基于低确定性发现.
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