[2023 - 2024年无创正压通气临床研究进展]。

Q Y Huang, S S Zha, L L Guan, Z F He, J Y Niu, R C Chen
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引用次数: 0

摘要

本综述对2023年10月1日至2024年9月30日Medline上有关无创正压通气(NPPV)治疗急性呼吸衰竭(ARF)和慢性呼吸衰竭(CRF)的临床研究进行了全面检索和检索。在用NPPV治疗ARF时,使用Digital Twins的实验表明,与自我造成的肺损伤相关的过度潮汐量可能导致NPPV失败。在NPPV期间给予镇静和镇痛被发现与死亡率增加相关。在慢性阻塞性肺疾病急性加重患者中,高强度NPPV可显著降低插管率。然而,作为初始治疗,高流量鼻插管氧疗(HFNC)的效果不如NPPV。在CRF患者的管理中,法国的一项研究基于法国国家医保报销系统数据库,检测了接受家庭NPPV治疗的COPD患者在NPPV前的健康轨迹,发现开始家庭NPPV治疗的时机对预后有显著影响。此外,研究发现,利用物联网技术的远程管理提高了患者与健康相关的生活质量,降低了再入院的风险。在预防再插管方面,不同的基础条件对NPPV治疗表现出不同的反应。具体来说,研究发现预防性使用NPPV可以降低肥胖外科患者的再插管风险,但对急性脑损伤患者则没有效果。在技术进步方面,bag - cpap是一种由储氧袋和中流量氧气组成的设备,已被证实是一种适用于资源有限环境的替代通气选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Clinical research progress in non-invasive positive pressure ventilation from 2023 to 2024].

The present review conducted a comprehensive search and retrieval of clinical studies related to non-invasive positive pressure ventilation (NPPV) for acute respiratory failure (ARF) and chronic respiratory failure (CRF) retrieved from Medline between October 1, 2023 and September 30, 2024. In the treatment of ARF with NPPV, experiments using Digital Twins had shown that excessive tidal volumes associated self-inflicted lung injury might contribute to NPPV failure. The administration of sedation and analgesia during NPPV was found to correlate with increased mortality. In patients with acute exacerbations of chronic obstructive pulmonary disease, high-intensity NPPV significantly reduced intubation rates. However, high-flow nasal cannula oxygen therapy (HFNC) was less effective than NPPV when used as an initial treatment. In the management of CRF patients, a Franch study examined the pre-NPPV health trajectory of COPD patients receiving home NPPV based on French national health insurance reimbursement system database and suggested that the timing of initiation of home NPPV treatment significantly influenced prognosis. In addition, the research found that remote management utilizing Internet of Things technology enhanced patients' health-related quality of life and reduced the risk of hospital readmission. In terms of preventing re-intubation, different underlying conditions exhibited different responses to NPPV treatment. Specifically, prophylactic use of NPPV was found to reduce the risk of reintubation in obese surgical patients, but not in those with acute brain injury. In terms of technological advancements, Bag-CPAP, a device consisting of an oxygen storage bag and medium flow oxygen, has been validated as an alternative ventilation choice suitable for resource-limited settings.

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