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[撤机中断的机械通气]

[Mechanical ventilation of weaning interruption].

作者信息

Goldwasser Rosane, Farias Augusto, Freitas Edna Estelita, Saddy Felipe, Amado Verônica, Okamoto Valdelis Novis

机构信息

Sociedade de Terapia Intensiva do Estado do Rio de Janeiro, RJ.

Hospital Português, Salvador, BA.

出版信息

Rev Bras Ter Intensiva. 2007 Sep;19(3):384-92.

Abstract

BACKGROUND AND OBJECTIVES

The II Brazilian Consensus Conference on Mechanical Ventilation was published in 2000. Knowledge on the field of mechanical ventilation evolved rapidly since then, with the publication of numerous clinical studies with potential impact on the ventilatory management of critically ill patients. Moreover, the evolving concept of evidence - based medicine determined the grading of clinical recommendations according to the methodological value of the studies on which they are based. This explicit approach has broadened the understanding and adoption of clinical recommendations. For these reasons, AMIB - Associação de Medicina Intensiva Brasileira and SBPT - Sociedade Brasileira de Pneumologia e Tisiologia - decided to update the recommendations of the II Brazilian Consensus. Weaning from mechanical ventilation has been one of the updated topics. This objective was described the most important topics related to weaning from mechanical ventilation.

METHODS

Systematic review of the published literature and gradation of the studies in levels of evidence, using the keywords weaning and mechanical ventilation.

RESULTS

Recommendations on the weaning from mechanical ventilation and how to select patients applying weaning protocols and spontaneous breathing test.

CONCLUSIONS

Weaning is a very important period of mechanical ventilatory support. Weaning protocols are recommended to select patients ready to be extubated.

摘要

背景与目的

第二届巴西机械通气共识会议于2000年发布。自那时起,机械通气领域的知识迅速发展,大量临床研究发表,这些研究可能对危重症患者的通气管理产生影响。此外,循证医学不断发展的理念决定了根据临床推荐所基于研究的方法学价值对其进行分级。这种明确的方法拓宽了对临床推荐的理解和采用。出于这些原因,巴西重症医学会(AMIB)和巴西肺病与胸科学会(SBPT)决定更新第二届巴西共识的推荐内容。机械通气撤机一直是更新的主题之一。本研究旨在描述与机械通气撤机相关的最重要主题。

方法

使用关键词“撤机”和“机械通气”对已发表文献进行系统综述,并对研究进行证据水平分级。

结果

关于机械通气撤机以及如何选择应用撤机方案和自主呼吸试验的患者的推荐。

结论

撤机是机械通气支持的一个非常重要的阶段。建议采用撤机方案来选择准备好拔管的患者。

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