在重症儿童中,保守与自由的氧化目标:Oxy-PICU RCT
Doug Gould1, Samiran Ray2, Irene Chang1
1Clinical Trials Unit, Intensive Care National Audit & Research Centre, London, UK.
在重症儿童中,保守的氧化位 (88-92% SpO2) 减少了器官支持续时间或在30天内死亡. 这种方法似乎是有益的,并可能在短期内节省成本.
科学领域:
- 儿科重症监护室的儿童重症监护室
- 关键护理医学 关键护理医学
- 呼吸系统生理学 呼吸系统生理学
背景情况:
- 对于重症儿童的最佳氧和目标仍然不确定.
- 在观察性研究中,自由的氧化策略可能与危害有关.
研究的目的:
- 为了比较保守的 (SpO2 88-92%) 与自由的 (SpO2 >94%) 氧化目标的临床和成本效益.
- 评估儿童入住儿科重症监护室 (PICU) 的儿童的治疗结果.
主要方法:
- 一项务实,开放,多中心,随机的临床试验,涉及1872名需要机械通风的儿童.
- 干预涉及调整通风器设置以实现保守或自由的氧化目标.
- 主要结局包括30天内器官支持或死亡的持续时间和12个月后的成本效益.
主要成果:
- 保守氧化显著减少了30天内器官支持或死亡的持续时间 (p=0.04).
- 二次结果和主要结果的组成部分有利于保守的氧化.
- 短期成本在保守的氧化时较低,但长期的成本效益显示出广泛的不确定性.
结论:
- 保守的氧化度目标 (SpO2 88-92%) 在重症儿童中显示出更高的改善结果的可能性.
- 长期生存和生活质量与主要发现一致.
- 保守的氧化可能会降低短期成本,但长期成本效益不确定.
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