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使用IntelliSync的自适应支通风与压力支通风用于COPD急性恶化的非侵入性通风:一个可行性随机试验
Selva Vijay1, Inderpaul Singh Sehgal1, Ritesh Agarwal1
1Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
使用IntelliSync的自适应式支持通风 (ASVi) 显示出减少慢性阻塞性肺病 (AECOPD) 急性恶化的非侵入性通风 (NIV) 失败的前景. 这种方法还改善了患者的舒适性,并缩短了与标准压力支通风相比的住院时间.
科学领域:
- 肺部医学 肺部医学
- 临界护理医学 临界护理医学
- 呼吸系统疗法 呼吸系统疗法
背景情况:
- 建议在慢性阻塞性肺病 (AECOPD) 的急性恶化中进行非侵入性通风 (NIV).
- 在AECOPD管理中,压力支通风 (PSV) 的故障率很高 (30-40%).
- 具有IntelliSync (ASVi) 的适应性支持通风提供了同步的呼吸传递,以满足患者的需求.
研究的目的:
- 评估在AECOPD患者中使用IntelliSync (ASVi) 进行自适应性支持通风的可行性.
- 为了比较ASVi和传统PSV之间的NIV故障率.
- 为更大的临床试验设计提供信息.
主要方法:
- 单中心随机对照试验 (RCT) 涉及55名AECOPD患者.
- 患者被随机分配 (1:1) 通过ASVi或PSV接受NIV.
- 主要结局:NIV失败 (需要输管);次要结局:异步指数,28天死亡率.
主要成果:
- 与ASVi相比,NIV失败的发生率为15.4%,与PSV相比为31% (相对风险降低50%).
- 异步指数在各组之间是相似的.
- ASVi与改善的患者舒适度 (P=0.048) 和更短的住院时间 (3.9 vs 5.8 天,P=0.021) 有关.
结论:
- 对于AECOPD管理来说,ASVi是安全的,也是可行的.
- ASVi显示了降低NIV失败率,改善舒适度和缩短住院时间的潜力.
- 需要在更大的试验中进行进一步的调查,以确认这些临床上有意义的发现.
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