沙特阿拉伯ARDS患者目前使用高流量鼻插管的做法和障碍:一项对医生的横断面研究

IF 2.1 Q2 MEDICINE, GENERAL & INTERNAL
Mohammed M. Alyami, Abdulelah M. Aldhahir, Abdullah A. Alqarni, Amal A. Alqahtani, Sara M. Homadi, Mohammed A. Almeshari, Nowaf Y. Alobaidi, Jaber S. Alqahtani, Rayan A. Siraj, Saeed M. Alghamdi, Ahmed H. Alasimi, Shorooq T. Alenazi, Bashaer O. Banakher, Abdallah Y. Naser, Mansour S. Majrshi, Hassan Alwafi
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引用次数: 0

摘要

背景与目的高流量鼻插管(HFNC)在临床中的应用越来越广泛;然而,医生对其在沙特阿拉伯急性呼吸窘迫综合征(ARDS)管理中的使用和相关障碍的看法仍未得到探讨。本研究旨在评估HFNC的实践,并确定ICU和呼吸内科医生在使用HFNC治疗ARDS患者时面临的障碍。方法于2022年12月22日至2023年7月15日对沙特阿拉伯呼吸内科和ICU内科医生进行横断面调查。数据以频率和百分比表示。结果共分析了987份回复,显示医生认为HFNC有助于缓解呼吸短促(686份,或69.5%),帮助说话和进食(649份,或65.8%),并可能预防插管(629份,或63.7%)。在HFNC实践方面,445名受访者(45.1%)报告其使用受机构协议约束,而679名受访者(68.8%)表示开始治疗是由医生决定的。此外,458人(46.4%)表示,启动HFNC治疗需要≥15l /min的流速。在考虑初始设置时,近一半(455人,46.09%)的人选择吸入氧气(FiO2)的比例在61%-80%之间,442人(44.8%)选择流量在30 - 40 L/min之间,476人(48.23%)选择温度为34°C。根据407(41.24%)的数据,每2 ~ 4 h减少5 ~ 10 L/min的气体流量是最合适的断奶方式,FiO2 <; 35%和气体流量<; 20 L/min应达到断开HFNC治疗。缺乏HFNC治疗知识是最常见的障碍(494例,或50.1%)。结论:医生对HFNC治疗的潜在益处有全面的了解。然而,初始设置的差异和标准化指南的缺乏对其在ARDS患者中的最佳应用提出了重大挑战。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Current Practice and Barriers to Using High-Flow Nasal Cannula Among ARDS Patients in Saudi Arabia: A Cross-Sectional Study of Physicians

Current Practice and Barriers to Using High-Flow Nasal Cannula Among ARDS Patients in Saudi Arabia: A Cross-Sectional Study of Physicians

Background and Aims

High-flow nasal cannula (HFNC) is increasingly utilized in clinical practice; however, the perspectives of physicians on its use and associated barriers in managing acute respiratory distress syndrome (ARDS) in Saudi Arabia remain unexplored. This study aims to evaluate HFNC practices and identify the barriers faced by ICU and respiratory physicians in utilizing HFNC for ARDS patients.

Methods

A cross-sectional survey was distributed between December 22, 2022, and July 15, 2023, to respiratory and ICU physicians in Saudi Arabia. Data are presented as frequencies and percentages.

Results

A total of 987 responses were analyzed, revealing that physicians perceive HFNC as beneficial for relieving shortness of breath (686, or 69.5%), helping with speech and eating (649, or 65.8%), and potentially preventing intubation (629, or 63.7%). In terms of HFNC practice, 445 respondents (45.1%) reported that its use is governed by institutional protocols, while 679 (68.8%) indicated that the decision to initiate therapy is made by physicians. Additionally, 458 (46.4%) stated that a flow rate of ≥ 15 L/min is necessary to start HFNC therapy. When considering initial settings, nearly half (455, or 46.09%) chose a fraction of inspired oxygen (FiO2) between 61%–80%, 442 (44.8%) chose a flow between 30 and 40 L/min, and 476 (48.23%) chose a temperature of 34°C. Reducing gas flow by 5–10 L/min every two to 4 h was the most appropriate way of weaning, according to 407 (41.24%), and both FiO2 < 35% and gas flow < 20 L/min should be achieved to disconnect HFNC therapy. Lack of knowledge about HFNC therapy was the most commonly reported barrier (494, or 50.1%).

Conclusion

Physicians demonstrated a comprehensive understanding of the potential benefits associated with HFNC therapy. However, variations in initial settings and the absence of standardized guidelines present significant challenges to its optimal application in patients with ARDS.

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来源期刊
Health Science Reports
Health Science Reports Medicine-Medicine (all)
CiteScore
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