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成人急性呼吸窘迫综合征机械通气患者的复苏策略：系统评价和荟萃分析。

Recruitment manoeuvres for adults with acute respiratory distress syndrome receiving mechanical ventilation: a systematic review and meta-analysis.

机构信息

Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China.

Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China.

出版信息

J Crit Care. 2019 Apr;50:1-10. doi: 10.1016/j.jcrc.2018.10.033. Epub 2018 Nov 3.

DOI:10.1016/j.jcrc.2018.10.033
PMID:30453220
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10013696/
Abstract

PURPOSE

To determine if recruitment manoeuvres (RMs) would decrease 28-day mortality of patients with acute respiratory distress syndrome (ARDS) compared with standard care.

MATERIALS AND METHODS

Relevant randomized controlled trials (RCTs) published prior to April 26, 2018 were systematically searched. The primary outcome was mortality. The secondary outcomes were oxygenation, barotrauma or pneumothorax, the need for rescue therapies. Data were pooled using the random effects model. And the quality of evidence was assessed by the GRADE system.

RESULTS

Of 3180 identified studies, 15 were eligibly included in our analysis (N = 2755 participants). In the primary outcome, RMs were not associated with reducing 28-day mortality (RR 0.90; 95% CI 0.74-1.09), ICU mortality (RR 0.92; 95% CI 0.74-1.1), and the in-hospital mortaliy (RR 1.02; 95% CI 0.93-1.12). In the secondary outcomes, RMs could improve oxygenation (MD 37.85; 95% CI 11.08-64.61), the rates of barotrauma (RR 1.42; 95% CI 0.83-2.42) and the need for rescue therapies (RR 0.69; 95% CI 0.42-1.12) did not show any difference in the ARDS patients with RMs.

CONCLUSIONS

Earlier meta-analyses found decreased mortality with RMs, in the contrary, our results indicate that RMs could improve oxygenation without detrimental effects, but it does not appear to reduce mortality.

摘要

目的

确定与标准治疗相比，募集手法（RM）是否会降低急性呼吸窘迫综合征（ARDS）患者 28 天的死亡率。

材料与方法

系统检索了截至 2018 年 4 月 26 日之前发表的相关随机对照试验（RCT）。主要结局为死亡率。次要结局为氧合、气压伤或气胸、需要抢救治疗。使用随机效应模型汇总数据。使用 GRADE 系统评估证据质量。

结果

在 3180 项已识别的研究中，有 15 项符合纳入标准，纳入本分析（N=2755 名参与者）。在主要结局方面，RM 与降低 28 天死亡率（RR 0.90；95%CI 0.74-1.09）、ICU 死亡率（RR 0.92；95%CI 0.74-1.1）和住院死亡率（RR 1.02；95%CI 0.93-1.12）无关。在次要结局方面，RM 可改善氧合（MD 37.85；95%CI 11.08-64.61），气压伤发生率（RR 1.42；95%CI 0.83-2.42）和需要抢救治疗（RR 0.69；95%CI 0.42-1.12）的比例在 RM 治疗的 ARDS 患者中没有差异。

结论

早期荟萃分析发现 RM 可降低死亡率，但我们的结果表明，RM 可改善氧合而无不良影响，但似乎不会降低死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e09c/10013696/c40210579329/gr16_lrg.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e09c/10013696/3c04945d0d92/gr11_lrg.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e09c/10013696/c40210579329/gr16_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e09c/10013696/145ace81dbc5/gr1_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e09c/10013696/ae5d7af417be/gr2_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e09c/10013696/8592686cbe86/gr3_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e09c/10013696/5d6a3638ffbf/gr4_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e09c/10013696/ca1fbf953453/gr5_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e09c/10013696/d63c03d0dadd/gr6_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e09c/10013696/c6a18191cc1d/gr7_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e09c/10013696/b55fe6c97706/gr8_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e09c/10013696/1cb7f907cda1/gr9_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e09c/10013696/97f53d8595cb/gr10_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e09c/10013696/3c04945d0d92/gr11_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e09c/10013696/db241100a0c2/gr12_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e09c/10013696/fe2d3286ef20/gr13_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e09c/10013696/0c56f3e1fd12/gr14_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e09c/10013696/05920cf38cb7/gr15_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e09c/10013696/c40210579329/gr16_lrg.jpg

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1
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2
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Ann Am Thorac Soc. 2017 Oct;14(Supplement_4):S304-S311. doi: 10.1513/AnnalsATS.201704-340OT.
3
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Crit Care Res Pract. 2023 Feb 22;2023:4675910. doi: 10.1155/2023/4675910. eCollection 2023.
4
The efficacy of different alveolar recruitment maneuvers in holmium laser lithotripsy surgery under general anesthesia using a laryngeal mask.喉罩全麻下钬激光碎石术中不同肺泡复张手法的效果。
BMC Anesthesiol. 2022 May 2;22(1):134. doi: 10.1186/s12871-022-01664-y.
5
Efficacy analysis of the lung recruitment maneuver in correcting pulmonary atelectasis in neurological intensive care unit-a retrospective study.神经重症监护病房中肺复张手法纠正肺不张的疗效分析——一项回顾性研究
Ann Transl Med. 2022 Mar;10(6):315. doi: 10.21037/atm-22-554.
6
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7
Incidence and outcomes of acute respiratory distress syndrome in intensive care units of mainland China: a multicentre prospective longitudinal study.中国内地重症监护病房急性呼吸窘迫综合征的发生率和结局：一项多中心前瞻性纵向研究。
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8
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9
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Intensive Care Med. 2020 Feb;46(Suppl 1):10-67. doi: 10.1007/s00134-019-05878-6.
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4
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5
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7
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8
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JAMA. 2016 Feb 23;315(8):788-800. doi: 10.1001/jama.2016.0291.
9
Use of thoracic electrical impedance tomography as an auxiliary tool for alveolar recruitment maneuvers in acute respiratory distress syndrome: case report and brief literature review.胸部电阻抗断层扫描作为急性呼吸窘迫综合征肺泡复张手法辅助工具的应用：病例报告及文献简要综述
Rev Bras Ter Intensiva. 2015 Oct-Dec;27(4):406-11. doi: 10.5935/0103-507X.20150068.
10
Open Lung Approach for the Acute Respiratory Distress Syndrome: A Pilot, Randomized Controlled Trial.急性呼吸窘迫综合征的开放肺通气方法：一项初步随机对照试验
Crit Care Med. 2016 Jan;44(1):32-42. doi: 10.1097/CCM.0000000000001383.