无创通气在急性重度哮喘中的应用：当前证据与未来展望。
Noninvasive ventilation in acute severe asthma: current evidence and future perspectives.
机构信息
aRespiratory Medicine, The Queen Elizabeth Hospital, Woodville South bThe Clinical Practice Unit, Basil Hetzel Institute for Translational Health Research, Woodville South cSchool of Medicine, The University of Adelaide, Adelaide, South Australia.
出版信息
Curr Opin Pulm Med. 2014 Jan;20(1):118-23. doi: 10.1097/MCP.0000000000000015.
PURPOSE OF REVIEW
The use of noninvasive positive pressure ventilation (NPPV) is often employed for the management of acute respiratory failure as an alternative to endotracheal intubation and mechanical ventilation. However, evidence to support the application of NPPV use in patients with acute severe asthma is less known.
RECENT FINDINGS
A paucity of evidence is available to support the use of NPPV as part of clinical care in patients with acute severe asthma. A number of small studies in adult and paediatric populations suggest that NPPV may have a beneficial role through improving respiratory rate and reducing the need for more invasive alternatives. Overall NPPV use appeared to be well tolerated with few reports of adverse events.
SUMMARY
Available evidence is limited by a small number of published trials and lack of methodological rigour in existing study design. There is a need for well conducted clinical studies to establish accurate treatment efficacy, safety and cost-effectiveness, in both the adult and paediatric setting.
目的综述
无创正压通气（NPPV）常用于治疗急性呼吸衰竭，作为气管插管和机械通气的替代方法。然而，关于 NPPV 在急性重症哮喘患者中的应用证据尚不清楚。
最近的发现
目前很少有证据支持将 NPPV 作为急性重症哮喘患者临床治疗的一部分。一些在成人和儿童人群中进行的小型研究表明，NPPV 通过改善呼吸频率和减少对更具侵入性替代方法的需求，可能具有有益作用。总体而言，NPPV 的使用耐受性良好，不良事件的报道很少。
总结
现有证据受到已发表试验数量少和现有研究设计方法学严谨性不足的限制。需要进行良好的临床研究，以在成人和儿童环境中确定准确的治疗效果、安全性和成本效益。
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