俯卧位通气装置的开发及联合生命支持技术在重症患者中的应用效果研究。

IF 2.1 4区 医学 Q3 RESPIRATORY SYSTEM Canadian respiratory journal Pub Date : 2024-08-19 eCollection Date: 2024-01-01 DOI:10.1155/2024/5812829
Yufeng Li, Qiaoqiao Hu, Wenjie Wang, Changhong Du, Siwen Fan, Linlin Xu, Songmei Li, Bei Chen
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引用次数: 0

摘要

研究目的本研究旨在对一种新型俯卧位通气装置进行评估,该装置旨在提高患者安全性、改善舒适度并减少不良事件,从而延长危重症患者的耐受时间:2020年1月至2023年6月,对60名重症患者进行了随机对照试验。其中,一名患者在治疗期间自行出院,另一名患者因氧合下降而终止治疗,因此有效样本为 58 名患者。患者被分配到接受传统俯卧定位辅助工具(普通海绵垫和枕头)的对照组或使用新开发的可调节俯卧定位装置的干预组。每组的一部分患者还接受了体外膜氧合(ECMO)和持续肾脏替代疗法(CRRT)等生命支持技术。我们评估了俯卧位通气耐受性、干预后血氧饱和度增量、俯卧位持续时间、CRRT 过滤器寿命和不良事件发生率:结果:干预组患者对俯卧位通气的平均耐受时间明显更长(16.6 小时 vs. 8.3 小时,P < 0.001,差异为 8.3 (4.4, 12.2) 小时),通气后血氧饱和度的升高幅度更大(9% vs. 6%,P < 0.001,差异为 8.3 (4.4, 12.2) 小时)。6% ,P < 0.001,差异为 3.0 (1.5, 4.5)),医护人员为患者定位所需的时间缩短(11.7 分钟对 21.8 分钟,P < 0.001,差异为 -10.1 (-11.9, -8.3))。干预组的不良事件明显减少,包括导管移位或堵塞、面部水肿、压伤、呕吐或吸入,差异有统计学意义(P < 0.05)。在接受联合生命支持的患者中,干预组改善了导管排血,延长了 CRRT 过滤器的使用寿命:结论:新开发的可调式俯卧位通气装置可显著提高重症患者对俯卧位的耐受性,增强氧合,并将不良事件降至最低,从而促进生命支持技术的有效应用。
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Development of Prone Position Ventilation Device and Study on the Application Effect of Combined Life Support Technology in Critically Ill Patients.

Objective: This study aims to evaluate a novel prone position ventilation device designed to enhance patient safety, improve comfort, and reduce adverse events, facilitating prolonged tolerance in critically ill patients.

Methods: A randomized controlled trial was conducted on 60 critically ill patients from January 2020 to June 2023. Of which, one self-discharged during treatment and another was terminated due to decreased oxygenation, leaving an effective sample of 58 patients. Patients were allocated to either a control group receiving traditional prone positioning aids (ordinary sponge pads and pillows) or an intervention group using a newly developed adjustable prone positioning device. A subset of patients in each group also received life support technologies such as extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT). We assessed prone position ventilation tolerance, oxygen saturation increments postintervention, duration of prone positioning, CRRT filter lifespan, and the incidence of adverse events.

Results: The intervention group exhibited significantly longer average tolerance to prone positioning (16.6 hours vs. 8.3 hours, P < 0.001 with a difference of 8.3 (4.4, 12.2) hours), higher increases in oxygen saturation postventilation (9% vs. 6%, P < 0.001 with a difference of 3.0 (1.5, 4.5)), and reduced time required for medical staff to position patients (11.7 min vs. 21.8 min, P < 0.001 with a difference of -10.1 (-11.9, -8.3)). Adverse events, including catheter displacement or blockage, facial edema, pressure injuries, and vomiting or aspiration, were markedly lower in the intervention group, with statistical significance (P < 0.05). In patients receiving combined life support, the intervention group demonstrated improved catheter blood drainage and extended CRRT filter longevity.

Conclusion: The newly developed adjustable prone ventilation device significantly improves tolerance to prone positioning, enhances oxygenation, and minimizes adverse events in critically ill patients, thereby also facilitating the effective application of life support technologies.

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来源期刊
Canadian respiratory journal
Canadian respiratory journal 医学-呼吸系统
CiteScore
4.20
自引率
0.00%
发文量
61
审稿时长
6-12 weeks
期刊介绍: Canadian Respiratory Journal is a peer-reviewed, Open Access journal that aims to provide a multidisciplinary forum for research in all areas of respiratory medicine. The journal publishes original research articles, review articles, and clinical studies related to asthma, allergy, COPD, non-invasive ventilation, therapeutic intervention, lung cancer, airway and lung infections, as well as any other respiratory diseases.
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