{"title":"急性低氧血症呼吸衰竭的氧气治疗：SRLF-SFMU 共识会议的指导方针。","authors":"Julie Helms, Pierre Catoire, Laure Abensur Vuillaume, Héloise Bannelier, Delphine Douillet, Claire Dupuis, Laura Federici, Melissa Jezequel, Mathieu Jozwiak, Khaldoun Kuteifan, Guylaine Labro, Gwendoline Latournerie, Fabrice Michelet, Xavier Monnet, Romain Persichini, Fabien Polge, Dominique Savary, Amélie Vromant, Imane Adda, Sami Hraiech","doi":"10.1186/s13613-024-01367-2","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Although largely used, the place of oxygen therapy and its devices in patients with acute hypoxemic respiratory failure (ARF) deserves to be clarified. The French Intensive Care Society (Société de Réanimation de Langue Française, SRLF) and the French Emergency Medicine Society (Société Française de Médecine d'Urgence, SFMU) organized a consensus conference on oxygen therapy in ARF (excluding acute cardiogenic pulmonary oedema and hypercapnic exacerbation of chronic obstructive diseases) in December 2023.</p><p><strong>Methods: </strong>A committee without any conflict of interest (CoI) with the subject defined 7 generic questions and drew up a list of sub questions according to the population, intervention, comparison and outcomes (PICO) model. An independent work group reviewed the literature using predefined keywords. The quality of the data was assessed using the GRADE methodology. Fifteen experts in the field from both societies proposed their own answers in a public session and answered questions from the jury (a panel of 16 critical-care and emergency medicine physicians, nurses and physiotherapists without any CoI) and the public. The jury then met alone for 48 h to write its recommendations.</p><p><strong>Results: </strong>The jury provided 22 statements answering 11 questions: in patients with ARF (1) What are the criteria for initiating oxygen therapy? (2) What are the targets of oxygen saturation? (3) What is the role of blood gas analysis? (4) When should an arterial catheter be inserted? (5) Should standard oxygen therapy, high-flow nasal cannula oxygen therapy (HFNC) or continuous positive airway pressure (CPAP) be preferred? (6) What are the indications for non-invasive ventilation (NIV)? (7) What are the indications for invasive mechanical ventilation? (8) Should awake prone position be used? (9) What is the role of physiotherapy? (10) Which criteria necessarily lead to ICU admission? (11) Which oxygenation device should be preferred for patients for whom a do-not-intubate decision has been made?</p><p><strong>Conclusion: </strong>These recommendations should optimize the use of oxygen during ARF.</p>","PeriodicalId":7966,"journal":{"name":"Annals of Intensive Care","volume":null,"pages":null},"PeriodicalIF":5.7000,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11377397/pdf/","citationCount":"0","resultStr":"{\"title\":\"Oxygen therapy in acute hypoxemic respiratory failure: guidelines from the SRLF-SFMU consensus conference.\",\"authors\":\"Julie Helms, Pierre Catoire, Laure Abensur Vuillaume, Héloise Bannelier, Delphine Douillet, Claire Dupuis, Laura Federici, Melissa Jezequel, Mathieu Jozwiak, Khaldoun Kuteifan, Guylaine Labro, Gwendoline Latournerie, Fabrice Michelet, Xavier Monnet, Romain Persichini, Fabien Polge, Dominique Savary, Amélie Vromant, Imane Adda, Sami Hraiech\",\"doi\":\"10.1186/s13613-024-01367-2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Although largely used, the place of oxygen therapy and its devices in patients with acute hypoxemic respiratory failure (ARF) deserves to be clarified. 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Fifteen experts in the field from both societies proposed their own answers in a public session and answered questions from the jury (a panel of 16 critical-care and emergency medicine physicians, nurses and physiotherapists without any CoI) and the public. The jury then met alone for 48 h to write its recommendations.</p><p><strong>Results: </strong>The jury provided 22 statements answering 11 questions: in patients with ARF (1) What are the criteria for initiating oxygen therapy? (2) What are the targets of oxygen saturation? (3) What is the role of blood gas analysis? (4) When should an arterial catheter be inserted? (5) Should standard oxygen therapy, high-flow nasal cannula oxygen therapy (HFNC) or continuous positive airway pressure (CPAP) be preferred? (6) What are the indications for non-invasive ventilation (NIV)? (7) What are the indications for invasive mechanical ventilation? (8) Should awake prone position be used? (9) What is the role of physiotherapy? 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引用次数: 0
摘要
导言：虽然氧疗及其设备在急性低氧性呼吸衰竭（ARF）患者中的应用已十分广泛，但其地位仍有待明确。法国重症监护学会（Société de Réanimation de Langue Française, SRLF）和法国急诊医学会（Société Française de Médecine d'Urgence, SFMU）于 2023 年 12 月组织了一次关于 ARF（不包括急性心源性肺水肿和慢性阻塞性疾病的高碳酸血症加重）氧疗的共识会议：一个与会议主题无任何利益冲突（CoI）的委员会确定了 7 个通用问题，并根据人群、干预、比较和结果（PICO）模型拟定了一份子问题清单。一个独立的工作组使用预先确定的关键词对文献进行了审查。数据质量采用 GRADE 方法进行评估。来自两个学会的 15 名该领域专家在公开会议上提出了自己的答案，并回答了评审团（由 16 名危重症和急诊科医生、护士和物理治疗师组成，无任何 CoI）和公众的提问。然后，评审团单独开会 48 小时撰写建议：评审团提供了 22 份声明，回答了 11 个问题：ARF 患者 (1) 启动氧疗的标准是什么？(2) 氧饱和度的目标是什么？(3) 血气分析的作用是什么？(4) 何时插入动脉导管？(5) 应首选标准氧疗、高流量鼻导管氧疗（HFNC）还是持续气道正压（CPAP）？(6) 无创通气（NIV）的适应症是什么？(7) 有创机械通气的适应症是什么？(8) 是否应采用清醒俯卧位？(9) 物理治疗的作用是什么？(10) 哪些标准必然导致入住 ICU？(11) 对于已决定不插管的患者，应首选哪种氧合设备？这些建议应能优化 ARF 期间氧气的使用。
Oxygen therapy in acute hypoxemic respiratory failure: guidelines from the SRLF-SFMU consensus conference.
Introduction: Although largely used, the place of oxygen therapy and its devices in patients with acute hypoxemic respiratory failure (ARF) deserves to be clarified. The French Intensive Care Society (Société de Réanimation de Langue Française, SRLF) and the French Emergency Medicine Society (Société Française de Médecine d'Urgence, SFMU) organized a consensus conference on oxygen therapy in ARF (excluding acute cardiogenic pulmonary oedema and hypercapnic exacerbation of chronic obstructive diseases) in December 2023.
Methods: A committee without any conflict of interest (CoI) with the subject defined 7 generic questions and drew up a list of sub questions according to the population, intervention, comparison and outcomes (PICO) model. An independent work group reviewed the literature using predefined keywords. The quality of the data was assessed using the GRADE methodology. Fifteen experts in the field from both societies proposed their own answers in a public session and answered questions from the jury (a panel of 16 critical-care and emergency medicine physicians, nurses and physiotherapists without any CoI) and the public. The jury then met alone for 48 h to write its recommendations.
Results: The jury provided 22 statements answering 11 questions: in patients with ARF (1) What are the criteria for initiating oxygen therapy? (2) What are the targets of oxygen saturation? (3) What is the role of blood gas analysis? (4) When should an arterial catheter be inserted? (5) Should standard oxygen therapy, high-flow nasal cannula oxygen therapy (HFNC) or continuous positive airway pressure (CPAP) be preferred? (6) What are the indications for non-invasive ventilation (NIV)? (7) What are the indications for invasive mechanical ventilation? (8) Should awake prone position be used? (9) What is the role of physiotherapy? (10) Which criteria necessarily lead to ICU admission? (11) Which oxygenation device should be preferred for patients for whom a do-not-intubate decision has been made?
Conclusion: These recommendations should optimize the use of oxygen during ARF.
期刊介绍：
Annals of Intensive Care is an online peer-reviewed journal that publishes high-quality review articles and original research papers in the field of intensive care medicine. It targets critical care providers including attending physicians, fellows, residents, nurses, and physiotherapists, who aim to enhance their knowledge and provide optimal care for their patients. The journal's articles are included in various prestigious databases such as CAS, Current contents, DOAJ, Embase, Journal Citation Reports/Science Edition, OCLC, PubMed, PubMed Central, Science Citation Index Expanded, SCOPUS, and Summon by Serial Solutions.
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