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儿童高流量鼻导管吸氧成功的临床因素

Clinical Factors of High-Flow Nasal Cannula Oxygen Success in Children.

作者信息

Iplik Gokce, Yildizdas Dincer, Yontem Ahmet

机构信息

Division of Pediatric Intensive Care Unit, Çukurova University Faculty of Medicine, Sarıçam, Adana, Turkey.

出版信息

J Pediatr Intensive Care. 2021 Jun 15;12(1):71-78. doi: 10.1055/s-0041-1730915. eCollection 2023 Mar.

Abstract

This study was aimed to evaluate the success rate of high-flow nasal cannula (HFNC) oxygen therapy and factors causing therapy failure. This prospective observational study included 131 children who received HFNC oxygen and followed-up in the pediatric emergency department, pediatric clinics, and pediatric intensive care unit between March 2018 and December 2019. The median age was 23.0 months (interquartile range [IQR]: 9.0-92.0) and 65 patients were male (49.6%). The most common reason for requiring HFNC oxygen therapy was pneumonia (  = 75, 57.3%). A complex chronic condition was present in 112 (85.5%) patients. Therapy success was achieved in 116 patients (88.5%). The reason for requiring treatment and the patients' complex chronic condition did not affect the success of the therapy (  = 0.294 and 0.091, respectively). In the first 24 hours of treatment, a significant improvement in pulse rate, respiratory rate, pH, and lactate level were observed in successful HFNC oxygen patients (  < 0.05). In addition, these patients showed a significant improvement in SpO and SpO /FiO ratio, and a significant decrease in FiO and flow rate (  < 0.05). HFNC oxygen success rate was 95.6% in patients with SpO /FiO ≥ 150 at the 24th hour; it was 58.0% in those with SpO /FiO  < 150 (  < 0.001). Caution should be exercised in terms of HFNC oxygen failure in patients with no significant improvement in vital signs and with SpO /FiO  < 150 during treatment.

摘要

本研究旨在评估高流量鼻导管(HFNC)氧疗的成功率及导致治疗失败的因素。这项前瞻性观察性研究纳入了131例接受HFNC氧疗并于2018年3月至2019年12月期间在儿科急诊科、儿科门诊和儿科重症监护病房接受随访的儿童。中位年龄为23.0个月(四分位间距[IQR]:9.0 - 92.0),65例患者为男性(49.6%)。需要HFNC氧疗的最常见原因是肺炎(n = 75,57.3%)。112例(85.5%)患者存在复杂慢性病。116例患者(88.5%)治疗成功。需要治疗的原因及患者的复杂慢性病均不影响治疗成功率(分别为P = 0.294和0.091)。在成功接受HFNC氧疗的患者中,治疗的前24小时,脉搏率、呼吸频率、pH值和乳酸水平有显著改善(P < 0.05)。此外,这些患者的SpO₂和SpO₂/FiO₂比值有显著改善,FiO₂和流速显著降低(P < 0.05)。第24小时SpO₂/FiO₂≥150的患者中,HFNC氧疗成功率为95.6%;SpO₂/FiO₂< 150的患者中,成功率为58.0%(P < 0.001)。对于治疗期间生命体征无显著改善且SpO₂/FiO₂< 150的患者,应警惕HFNC氧疗失败。

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Clinical Factors of High-Flow Nasal Cannula Oxygen Success in Children.儿童高流量鼻导管吸氧成功的临床因素
J Pediatr Intensive Care. 2021 Jun 15;12(1):71-78. doi: 10.1055/s-0041-1730915. eCollection 2023 Mar.

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