High frequency percussive ventilation in pediatric acute respiratory failure.
High frequency percussive ventilation in pediatric acute respiratory failure.
复制标题
高频膨胀通气治疗小儿急性呼吸衰竭。
DOI：
10.1002/ppul.25191
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发表时间：
2021-03
影响因子：
3.1
通讯作者：
Yehya N
中科院分区：
文献类型：
--
作者：
Butler AD;Dominick CL;Yehya N
高频扩张通气（HFPV）用于急性呼吸衰竭（ARF），但在儿科中的描述很少。我们的目的是描述一个大型儿科队列的临床特征、呼吸机设置和结局，并确定谁将从HFPV中获益的预测因素。在HFPV启动后2小时进行气体交换可预测成功。单中心回顾性队列研究，测试HFPV启动后2小时气体交换与成功之间的关联，先验定义。2012年至2018年期间接受HFPV ≥ 2小时插管的儿童。我们描述了适应症，呼吸机设置和气体交换之前，2小时后，并在终止HFPV。单因素和多因素回归分析检测HFPV启动后氧合和通气与成功的相关性。计算受试者工作特征（AUROC）曲线下面积和校正比值比（aOR）。我们对193名儿童（22%非幸存者）进行了237个疗程的HFPV，其中162名（68%）成功。在单变量分析中，HFPV后两小时的pH值（AUROC 0.65）和PCO 2（AUROC 0.66）预测成功。在多变量分析中，HFPV启动后2小时的pH值（aOR 1.67/1 SD，95% CI 1.19 - 2.35）、PCO 2（aOR 0.49/1 SD，95% CI 0.31 - 0.79）和氧合指数（aOR 0.66/1 SD，95% CI 0.44 - 0.97）与成功相关。我们描述了迄今为止最大的HFPV队列，并详细描述了适应症和设置。HFPV两小时后的气体交换与成功独立相关。
High frequency percussive ventilation (HFPV) is used in acute respiratory failure (ARF), but is poorly described in pediatrics. We aimed to describe the clinical characteristics, ventilator settings, and outcomes of a large pediatric cohort, and to determine predictors of who would benefit from HFPV. Gas exchange two hours after HFPV initiation predicts success. Single center retrospective cohort study testing association between gas exchange two hours after HFPV initiation with success, defined a priori. Intubated children on HFPV for ≥ 2 hours from 2012 to 2018. We described indications, ventilator settings, and gas exchange immediately prior to, 2 hours after, and at termination of HFPV. Univariate and multivariate regression tested association of oxygenation and ventilation after HFPV initiation with success. Areas under the receiver operating characteristic (AUROC) curve and adjusted odds ratios (aORs) were computed. We performed 237 courses of HFPV in 193 children (22% non-survivors), of which 162 (68%) were successful. In univariate analysis, pH (AUROC 0.65) and PCO2 (AUROC 0.66) two hours after HFPV predicted success. In multivariate analysis, pH (aOR 1.67 per 1 SD, 95% CI 1.19 to 2.35), PCO2 (aOR 0.49 per 1 SD, 95% CI 0.31 to 0.79), and oxygenation index (aOR 0.66 per 1 SD, 95% CI 0.44 to 0.97) two hours after HFPV initiation were associated with success. We describe the largest cohort of HFPV to date, with detailed description of indications and settings. Gas exchange after two hours of HFPV was independently associated with success.
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影响因子：
4.1
作者：
Gaies, Michael G.;Gurney, James G.;Hirsch, Jennifer C.
通讯作者：
Hirsch, Jennifer C.
影响因子：
0.7
作者：
Tawfik, Daniel S.;Bennett, Tellen D.;Poss, W. Bradley
通讯作者：
Poss, W. Bradley
DOI：
10.1164/rccm.201909-1807oc
发表时间：
2020-06-01
影响因子：
24.7
作者：
Rowan, Courtney M.;Klein, Margaret J.;Yehya, Nadir
通讯作者：
Yehya, Nadir
影响因子：
8.8
作者：
Guervilly, Christophe;Forel, Jean-Marie;Roch, Antoine
通讯作者：
Roch, Antoine
影响因子：
2.5
作者：
Kallet, Richard H.
通讯作者：
Kallet, Richard H.