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2019年冠状病毒病患者使用流量计头盔接口与机械通气进行无创通气的有效性比较。对照随机临床试验。

Comparison of the effectiveness of the helmet interface using flow meters versus the mechanical ventilator for non-invasive ventilation in patients with coronavirus disease 2019. Controlled and randomized clinical trial.

作者信息

Dos Reis Ferreira Fernanda, Correa João Carlos Ferrari, Storopoli Eduardo, Faria Diego Restivo, Cassaro Karina, Feitosa da Hora Natália, Ritti Raphael, Becker Rafael Akira, Dal Corso Simone, Costa Ivan Peres, Sampaio Luciana Maria Malosá

机构信息

Universidade Nove de Julho, Sao Paulo, Brazil.

Associação Paulista para Desenvolvimento da Medicina (SPDM), Hospital Lydia Storópoli, Sao Paulo, Brazil.

出版信息

Arch Med Sci. 2024 May 28;20(5):1538-1546. doi: 10.5114/aoms/183947. eCollection 2024.

Abstract

INTRODUCTION

This study aimed to compare the effectiveness of two methods for non-invasive mechanical ventilation in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) - using a helmet interface with a flow meter and positive end-expiratory pressure valve versus a traditional mechanical ventilator.

MATERIAL AND METHODS

We conducted a single-center randomized clinical trial involving 100 adult SARS-CoV-2 patients in a specialized private hospital. Participants were randomly assigned to two groups: one using the helmet interface with a flow meter and positive end-expiratory pressure valve and the other employing conventional mechanical ventilation. Our study included participant selection, blood gas analysis, assessment of respiratory rate, peripheral oxygen saturation, modified Borg scale scores, and a visual analog scale.

RESULTS

The study showed no significant difference in intubation rates between the mechanical ventilation (54.3%) and helmet interface with flow meter and positive end-expiratory pressure valve (46.8%) groups ( = 0.37). Additionally, the helmet group had a shorter average duration of use (3.4 ±1.6 days) compared to the mechanical ventilation group (4.0 ±1.9 days). The helmet group also had a shorter average hospitalization duration (15.9 ±7.9 days) compared to the mechanical ventilation group (17.1 ±9.5 days).

CONCLUSIONS

This single-center randomized clinical trial found no statistically significant differences between the two methods of non-invasive ventilation. Implications for clinical practice: using the helmet interface with the flow meter and positive end-expiratory pressure valve can simplify device installation, potentially reducing the need for intubation, making it a valuable tool for nurses and physiotherapists in daily clinical practice.

摘要

引言

本研究旨在比较两种无创机械通气方法对严重急性呼吸综合征冠状病毒2(SARS-CoV-2)患者的有效性,即使用带有流量计和呼气末正压阀的头盔接口与传统机械通气机。

材料与方法

我们在一家专业私立医院进行了一项单中心随机临床试验,纳入了100名成年SARS-CoV-2患者。参与者被随机分为两组:一组使用带有流量计和呼气末正压阀的头盔接口,另一组采用传统机械通气。我们的研究包括参与者选择、血气分析、呼吸频率评估、外周血氧饱和度、改良Borg量表评分和视觉模拟量表。

结果

研究表明,机械通气组(54.3%)和带有流量计和呼气末正压阀的头盔接口组(4,6.8%)的插管率无显著差异(P = 0.37)。此外,头盔组的平均使用时间(3.4±1.6天)比机械通气组(4.0±1.9天)短。头盔组的平均住院时间(15.9±7.9天)也比机械通气组(17.1±9.5天)短。

结论

这项单中心随机临床试验发现两种无创通气方法之间无统计学显著差异。对临床实践的启示:使用带有流量计和呼气末正压阀的头盔接口可以简化设备安装,可能减少插管需求,使其成为护士和物理治疗师日常临床实践中的一个有价值的工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5878/11623150/f96bceb6284b/AMS-20-5-183947-g001.jpg

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