Official ERS/ATS clinical practice guidelines: noninvasive ventilation for acute respiratory failure
Official ERS/ATS clinical practice guidelines: noninvasive ventilation for acute respiratory failure
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DOI：
10.1183/13993003.02426-2016
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发表时间：
2017-08-01
影响因子：
24.3
通讯作者：
Raoof, Suhail
中科院分区：
文献类型：
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作者：
Rochwerg, Bram;Brochard, Laurent;Raoof, Suhail
无创机械通气 (NIV) 广泛应用于各种病因的急性呼吸衰竭 (ARF) 的急性护理环境中。本文件根据最新文献，提供了欧洲呼吸学会/美国胸科学会对 NIV 临床应用的建议。指导委员会由 NIV 领域的临床医生、方法学家和专家组成。委员会根据 GRADE（分级、推荐、评估、制定和评估）方法为每个可操作问题制定建议。指南开发工具中的 GRADE Evidence to Decision 框架用于生成建议。使用技术摘要解决了许多主题，但没有提出建议，这些主题在补充材料中进行了讨论。该指南委员会以 PICO（人口干预-比较-结果）格式提出了 11 个可操作问题的建议，所有这些都涉及使用 NIV 治疗 ARF 的各种病因。提出建议的具体情况包括慢性阻塞性肺病恶化、心源性肺水肿、新发低氧性呼吸衰竭、免疫功能低下患者、胸部创伤、姑息治疗、术后护理、脱机和拔管后。本文件总结了有关 NIV 在 ARF 中作用的最新知识。基于证据的建议为相关利益相关者提供指导。
Noninvasive mechanical ventilation (NIV) is widely used in the acute care setting for acute respiratory failure (ARF) across a variety of aetiologies. This document provides European Respiratory Society/American Thoracic Society recommendations for the clinical application of NIV based on the most current literature.The guideline committee was composed of clinicians, methodologists and experts in the field of NIV. The committee developed recommendations based on the GRADE (Grading, Recommendation, Assessment, Development and Evaluation) methodology for each actionable question. The GRADE Evidence to Decision framework in the guideline development tool was used to generate recommendations. A number of topics were addressed using technical summaries without recommendations and these are discussed in the supplementary material.This guideline committee developed recommendations for 11 actionable questions in a PICO (populationintervention- comparison-outcome) format, all addressing the use of NIV for various aetiologies of ARF. The specific conditions where recommendations were made include exacerbation of chronic obstructive pulmonary disease, cardiogenic pulmonary oedema, de novo hypoxaemic respiratory failure, immunocompromised patients, chest trauma, palliation, post-operative care, weaning and post-extubation.This document summarises the current state of knowledge regarding the role of NIV in ARF. Evidencebased recommendations provide guidance to relevant stakeholders.