在儿科危重症护理中剪裁通气和呼吸管理:用精准医学优化护理。

IF 2.2 3区 医学 Q2 PEDIATRICS
Current opinion in pediatrics Pub Date : 2025-06-01 Epub Date: 2025-02-12 DOI:10.1097/MOP.0000000000001449
Francis-Olivier Beauchamp, Julie Thériault, Michaël Sauthier
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引用次数: 0

摘要

回顾目的:重症监护病房的危重儿童经常需要呼吸护理来支持肺功能。机械通风是一个复杂的领域,需要设置多个参数。精准医疗的发展将使临床医生能够个性化呼吸护理并改善患者的预后。最近的发现:肺和膈超声,电阻抗断层扫描,神经调节通气辅助通气,以及机器学习模型中监测数据的使用越来越多地用于定制护理。每种模式都提供了对患者呼吸系统功能不同方面的见解,并使治疗调整能够更好地支持患者的生理。呼吸护理中的精准医学与减少通气时间、增加拔管和换气断奶成功率以及提高识别表型以指导治疗和预测结果的能力有关。本综述将重点关注精准医学在儿童急性呼吸窘迫综合征、哮喘、细支气管炎、拔管准备试验和通气脱机、通气获得性肺炎和其他呼吸道感染中的应用。总结:精准医疗正在革新呼吸系统护理,并将减少与通气相关的并发症。需要更多的研究来规范其使用,并更好地评估其对患者预后的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Tailoring ventilation and respiratory management in pediatric critical care: optimizing care with precision medicine.

Purpose of review: Critically ill children admitted to the intensive care unit frequently need respiratory care to support the lung function. Mechanical ventilation is a complex field with multiples parameters to set. The development of precision medicine will allow clinicians to personalize respiratory care and improve patients' outcomes.

Recent findings: Lung and diaphragmatic ultrasound, electrical impedance tomography, neurally adjusted ventilatory assist ventilation, as well as the use of monitoring data in machine learning models are increasingly used to tailor care. Each modality offers insights into different aspects of the patient's respiratory system function and enables the adjustment of treatment to better support the patient's physiology. Precision medicine in respiratory care has been associated with decreased ventilation time, increased extubation and ventilation wean success and increased ability to identify phenotypes to guide treatment and predict outcomes. This review will focus on the use of precision medicine in the setting of pediatric acute respiratory distress syndrome, asthma, bronchiolitis, extubation readiness trials and ventilation weaning, ventilation acquired pneumonia and other respiratory tract infections.

Summary: Precision medicine is revolutionizing respiratory care and will decrease complications associated with ventilation. More research is needed to standardize its use and better evaluate its impact on patient outcomes.

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来源期刊
CiteScore
6.20
自引率
0.00%
发文量
184
审稿时长
6-12 weeks
期刊介绍: ​​​​​Current Opinion in Pediatrics is a reader-friendly resource which allows the reader to keep up-to-date with the most important advances in the pediatric field. Each issue of Current Opinion in Pediatrics contains three main sections delivering a diverse and comprehensive cover of all key issues related to pediatrics; including genetics, therapeutics and toxicology, adolescent medicine, neonatology and perinatology, and orthopedics. Unique to Current Opinion in Pediatrics is the office pediatrics section which appears in every issue and covers popular topics such as fever, immunization and ADHD. Current Opinion in Pediatrics is an indispensable journal for the busy clinician, researcher or student.
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