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[机械通气患者机械通气辅助呼吸临床应用专家推荐意见(2024年)]

[Expert recommendations on the clinical application of mechanical insufflation-exsufflation in mechanically ventilated patients (2024)].

作者信息

Chinese Society Of Critical Care Medicine, Critical Care Medicine Branch Of Beijing Association Of Holistic Integrative Medicine

机构信息

Corresponding author: Wang Yuefu, Department of Surgical Critical Care Medicine, Emergency and Critical Care Medical Center, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, Email:

出版信息

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2024 Aug;36(8):785-795. doi: 10.3760/cma.j.cn121430-20240508-00408.

Abstract

Mechanical ventilated patients are a high-risk group with impaired cough ability and require corresponding medical techniques for cough assistance to clear airway secretions. Mechanical insufflation-exsufflation (MI-E) technology is widely used in patients with cough weakness caused by neuromuscular diseases. However, there is currently a lack of standardized application procedures for mechanically ventilated patients who retain artificial airways, which can affect treatment outcomes. Chinese Society of Critical Care Medicine organized experts including critical care physicians, nurses, respiratory therapists that focused on the clinical application of mechanical insufflation-exsufflation in mechanically ventilated patients. Through systematic collection, extraction, and summary of evidence-based clinical practice evidence and clinical experience, suggestions are proposed. Expert recommendations on the clinical application of mechanical insufflation-exsufflation in mechanically ventilated patients (2024) was formed by using improved Delphi method, hoping to provide references for standardized application of this technology. At the same time, those recommendations will also provide a reference for future clinical research on the application of mechanical insufflation-exsufflation technology in mechanically ventilated patients.

摘要

机械通气患者是咳嗽能力受损的高危人群,需要相应的咳嗽辅助医疗技术来清除气道分泌物。机械通气-呼气末正压通气(MI-E)技术广泛应用于神经肌肉疾病所致咳嗽无力的患者。然而,目前对于保留人工气道的机械通气患者缺乏标准化的应用程序,这可能会影响治疗效果。中华医学会重症医学分会组织了包括重症医学医师、护士、呼吸治疗师在内的专家,重点关注机械通气-呼气末正压通气在机械通气患者中的临床应用。通过系统收集、提取和总结循证临床实践证据及临床经验,提出了建议。采用改进的德尔菲法形成了《机械通气-呼气末正压通气在机械通气患者中临床应用的专家推荐(2024)》,希望为该技术的标准化应用提供参考。同时,这些推荐也将为未来机械通气-呼气末正压通气技术在机械通气患者中应用的临床研究提供参考。

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