HIGH-FLOW OXYGEN THERAPY TO SPEED WEANING FROM MECHANICAL VENTILATION: A PROSPECTIVE RANDOMIZED STUDY
HIGH-FLOW OXYGEN THERAPY TO SPEED WEANING FROM MECHANICAL VENTILATION: A PROSPECTIVE RANDOMIZED STUDY
复制标题
高流量氧气疗法加速机械通气脱机：一项前瞻性随机研究
DOI：
10.4037/ajcc2019130
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发表时间：
2019-09-01
影响因子：
2.7
通讯作者：
Qian, Kejian
中科院分区：
文献类型：
--
作者：
Liu, Fen;Shao, Qiang;Qian, Kejian
目的探讨高流量氧疗是否能提高机械通气患者的脱机效率。方法采用前瞻性单中心研究方法，将接受机械通气的患者随机分为3组，每组10例（T型管、压力支持通气或高流量氧气）。结果268例患者中，90例被分配到T型管组，96例被分配到压力支持通气组，82例被分配到高流量氧组。压力支持通气组和高流量吸氧组第一天2小时自主呼吸试验通过率高于T管组（P < .05）。压力支持通气组和高流量氧疗组通过自主呼吸试验所需的时间短于T管组（P <0.05）。高流量氧组的再插管率低于T管组和压力支持通气组，第1天脱机成功率高于T管组和压力支持通气组（P <0.05）。结论高流量氧疗可缩短患者通过自主呼吸试验的时间，降低再插管率，缩短患者机械通气的脱机时间。
Background High-flow oxygen therapy has been widely adopted, but its use for weaning patients from mechanical ventilation has not been reported.Objective To evaluate whether high-flow oxygen therapy improves the efficiency of weaning patients from mechanical ventilation.Methods In a single-center, prospective study, patients receiving mechanical ventilation were randomly assigned to 1 of 3 groups (T-tube, pressure support ventilation, or high-flow oxygen) during 2-hour spontaneous breathing trials in a 14-day study. Participants were followed up until hospital discharge or death.Results Of 268 patients included, 90 were assigned to the T-tube group, 96 to the pressure support ventilation group, and 82 to the high-flow oxygen group. The first-day 2-hour spontaneous breathing trial passing rates were higher in the pressure support ventilation and high-flow oxygen groups than in the T-tube group (P < .05). The time needed to pass the spontaneous breathing trial was less in the pressure support ventilation and high-flow oxygen groups than in the T-tube group (P < .05). The reintubation rate was lower and the successful weaning rate on the first day was higher in the high-flow oxygen group than in the T-tube and pressure support ventilation groups (P < .05). During the 14-day study period, the weaning time was less in the high-flow oxygen group than in the T-tube and pressure support ventilation groups (P < .05).Conclusion High-flow oxygen therapy can reduce the time needed to wean patients from mechanical ventilation by shortening the time needed to pass a spontaneous breathing trial and by decreasing the reintubation rate.