Pressure Support Ventilation Versus T-piece as Spontaneous Breathing Trials for Extubation of Patients with Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

IF 4.6 2区医学 Q1 RESPIRATORY SYSTEM Lung Pub Date : 2024-04-01 Epub Date: 2024-03-12 DOI:10.1007/s00408-024-00678-2

Luiza Mendes Fonseca, Pedro Matos da Câmara, Iane Miguel Pereira Lettieri, Caroline Serafim Dagostin, Arthur Oswaldo de Abreu Vianna

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引用次数: 0

Abstract

Background: Weaning patients with COPD from mechanical ventilation (MV) presents a challenge, as literature on this topic is limited. This study compares PSV and T-piece during spontaneous breathing trials (SBT) in this specific population.

Methods: A search of PubMed, EMBASE, and Cochrane in September 2023 yielded four randomized controlled trials (RCTs) encompassing 560 patients. Among these, 287 (51%) used T-piece during SBTs.

Results: The PSV group demonstrated a significant improvement in the successful extubation rate compared to the T-piece (risk ratio [RR] 1.14; 95% confidence interval [CI] 1.03-1.26; p = 0.02). Otherwise, there was no statistically significant difference in the reintubation (RR 1.07; 95% CI 0.79-1.45; p = 0.67) or the ICU mortality rates (RR 0.99; 95% CI 0.63-1.55; p = 0.95).

Conclusion: Although PSV in SBTs exhibits superior extubation success, consistent weaning protocols warrant further exploration through additional studies.

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慢性阻塞性肺病患者拔管时的压力支持通气与 T 片作为自主呼吸试验：随机对照试验的系统回顾和元分析》。

背景：慢性阻塞性肺病（COPD）患者从机械通气（MV）中断气是一项挑战，因为相关文献十分有限。本研究比较了这一特殊人群在自主呼吸试验（SBT）期间的 PSV 和 T-piece：方法：2023 年 9 月对 PubMed、EMBASE 和 Cochrane 的检索结果显示，有四项随机对照试验 (RCT)，共涉及 560 名患者。其中，287 人（51%）在 SBT 过程中使用了 T-piece：结果：PSV 组的成功拔管率明显高于 T-piece（风险比 [RR] 1.14；95% 置信区间 [CI] 1.03-1.26；P = 0.02）。此外，再次插管率（RR 1.07；95% CI 0.79-1.45；P = 0.67）和重症监护病房死亡率（RR 0.99；95% CI 0.63-1.55；P = 0.95）在统计学上没有显著差异：结论：尽管SBTs中的PSV显示出更高的拔管成功率，但仍需通过更多研究进一步探索一致的断奶方案。

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来源期刊

Lung 医学-呼吸系统

CiteScore

9.10

自引率

10.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Lung publishes original articles, reviews and editorials on all aspects of the healthy and diseased lungs, of the airways, and of breathing. Epidemiological, clinical, pathophysiological, biochemical, and pharmacological studies fall within the scope of the journal. Case reports, short communications and technical notes can be accepted if they are of particular interest.