急性低氧性呼吸衰竭中无创呼吸支持的个体化：临床医生的实用方法
Tailoring non-invasive respiratory supports in acute hypoxemic respiratory failure: A practical approach for clinicians.
作者信息
Pittao Maria Laura Vega, Nava Stefano, Hill Nicholas S, Pisani Lara
机构信息
Alma Mater Studiorum, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Via Massarenti 9, Bologna, Italy.
Alma Mater Studiorum, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Via Massarenti 9, Bologna, Italy; Respiratory and Critical Care Unit, IRCCS Azienda Ospedaliero Universitaria di Bologna, Italy.
出版信息
Eur J Intern Med. 2025 Jul;137:21-32. doi: 10.1016/j.ejim.2025.04.018. Epub 2025 May 2.
The use of non-invasive respiratory support (NIRS) for acute respiratory failure (ARF), particularly hypoxemic respiratory failure, has advanced in recent years, especially during the COVID-19 pandemic. NIRS modalities like high-flow nasal cannula (HFNC), continuous positive airway pressure (CPAP), and non-invasive ventilation (NIV) have shown efficacy, though evidence is inconsistent, especially for "de novo" acute hypoxemic respiratory failure (AHRF). This review outlines the physiological rationale for NIRS and offers practical guidance on tailoring treatment to individual patients. Successful AHRF management with NIRS requires a personalized approach, guided by clinical expertise. Further research is needed to refine patient selection and optimize NIRS application.
近年来，尤其是在新冠疫情期间，无创呼吸支持（NIRS）在急性呼吸衰竭（ARF），特别是低氧性呼吸衰竭中的应用取得了进展。高流量鼻导管（HFNC）、持续气道正压通气（CPAP）和无创通气（NIV）等无创呼吸支持方式已显示出疗效，尽管证据并不一致，尤其是对于“新发”急性低氧性呼吸衰竭（AHRF）。本综述概述了无创呼吸支持的生理原理，并为根据个体患者情况调整治疗提供实用指导。无创呼吸支持成功管理急性低氧性呼吸衰竭需要个性化方法，并以临床专业知识为指导。需要进一步研究以优化患者选择并完善无创呼吸支持的应用。
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