支气管炎患儿的高流量鼻插管氧疗:实施国家指南。

IF 2.4 4区 医学 Q1 PEDIATRICS
Acta Paediatrica Pub Date : 2024-12-30 DOI:10.1111/apa.17566
Nike Beckeringh, Rosalie S N Linssen, Berber Kapitein, Job B M van Woensel, Frans B Plötz
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引用次数: 0

摘要

目的:高流量鼻插管(HFNC)治疗是一种用于儿童毛细支气管炎呼吸支持的形式。2020年,荷兰发布了HFNC国家使用指南。我们研究了该指南的实现和使用。方法:我们在荷兰西北部所有涉及同一儿科重症监护室(PICU)的医院中进行了一项多中心观察性研究。本研究由两部分组成:地方HFNC方案与国家指南的比较,以及参与中心儿科医生HFNC使用情况的调查。结果:我们观察到地方方案和国家方案之间存在相当大的差异,特别是在开始HFNC治疗的标准和断奶实践方面。调查结果显示,人们对HFNC的期望差异很大,而HFNC的临床使用既偏离了国家指南,也偏离了地方方案,特别是在断奶实践和使用二氧化碳分压作为启动和评估HFNC效果的参数方面。结论:HFNC治疗毛细支气管炎的国家指南执行效果不佳,导致临床实践不统一。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
High-flow nasal cannula oxygen therapy for children with bronchiolitis: Implementation of a national guideline.

Aim: High flow nasal cannula (HFNC) therapy is a form of respiratory support used in children with bronchiolitis. A national guideline for the use of HFNC was published in The Netherlands in 2020. We studied the implementation and use of this guideline.

Methods: We performed a multicentre observational study amongst all hospitals in the North-West part of The Netherlands referring to the same paediatric intensive care unit (PICU). This study consisted of two parts: a comparison of local HFNC protocols to the national guideline and a survey about the use of HFNC amongst paediatricians in the participating centres.

Results: We observed considerable variations between the local protocols and the national protocol, especially regarding criteria to initiate HFNC treatment and weaning practices. Survey results showed that expectations of HFNC widely varied, while the clinical use of HFNC deviated from both the national guideline as well as local protocols, especially for weaning practices and the use of pCO2 as a parameter for initiation and evaluation of the effect of HFNC.

Conclusion: Implementation of the national guideline for HFNC therapy in bronchiolitis was inefficacious, leading to non-uniform clinical practice.

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来源期刊
Acta Paediatrica
Acta Paediatrica 医学-小儿科
CiteScore
6.50
自引率
5.30%
发文量
384
审稿时长
2-4 weeks
期刊介绍: Acta Paediatrica is a peer-reviewed monthly journal at the forefront of international pediatric research. It covers both clinical and experimental research in all areas of pediatrics including: neonatal medicine developmental medicine adolescent medicine child health and environment psychosomatic pediatrics child health in developing countries
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