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危重症儿科患者的通气实践:一项国际长期观察性研究方案及初步可行性研究结果

Practice of ventilation in critically ill pediatric patients: protocol for an international, long-term, observational study, and results of the pilot feasibility study.

作者信息

van Vliet Relin, Melger Jonathan Willem Jochem, Paulus Frederique, Bem Reinout Alexander, Blokpoel Robert Gorge Theodoor, Schultz Marcus Josephus, van Meenen David Michael Paul, Kneyber Martin Christiaan Jacques

机构信息

Department of Intensive Care, Amsterdam University Medical Centers - Amsterdam, The Netherlands.

Department of Paediatrics, Division of Paediatric Critical Care Medicine, Beatrix Children's Hospital, University Medical Center Groningen - Groningen, The Netherlands.

出版信息

Crit Care Sci. 2025 May 26;37:e20250398. doi: 10.62675/2965-2774.20250398. eCollection 2025.

Abstract

OBJECTIVE

This manuscript describes the protocol of an investigator-initiated, international, multicenter, long-term, prospective observational study named PRactice of VENTilation in PEDiatric Patients (PRoVENT-PED), designed to investigate the epidemiology, respiratory support practices and outcomes of critically ill pediatric patients.

DESIGN

Data will be collected biannually over 10 years during predefined 4-week intervals, with an additional optional period to accommodate data collection during an epidemic or pandemic. The specific focus of PRoVENT-PED will evolve as the study progresses, initially emphasizing collecting detailed ventilator data from invasively ventilated patients. In later phases, the focus will shift to noninvasive respiratory support and typical aspects of respiratory support, like patient-ventilator asynchronies, weaning practices, and rescue therapies, as extracorporeal support. PRoVENT-PED includes patients under 18 years of age, admitted to a participating intensive care unit, and receiving respiratory support. The endpoints vary with the focus in each phase but will always include a set of key settings and ventilation parameters and related outcomes. If applicable, potentially modifiable factors and associations with outcomes will be studied. The pilot feasibility study demonstrated that the electronic capturing system effectively collects all necessary data within a reasonable time limit, with little missing data.

CONCLUSION

PRoVENT-PED is a 10-year, international, multicenter study focused on collecting data on respiratory support practices in critically ill pediatric patients. Its scope evolves from invasive to noninvasive ventilatory support, ultimately encompassing patient-ventilator asynchronies, weaning practices, and rescue therapies.

摘要

目的

本手稿描述了一项由研究者发起的国际多中心长期前瞻性观察性研究的方案,该研究名为小儿患者通气实践(PRoVENT-PED),旨在调查危重症小儿患者的流行病学、呼吸支持实践及预后。

设计

在10年期间,每半年在预先设定的4周时间间隔内收集数据,另外还有一个可选时间段,以适应在流行病或大流行期间的数据收集。随着研究的进展,PRoVENT-PED的具体重点将不断演变,最初强调从有创通气患者中收集详细的呼吸机数据。在后期阶段,重点将转向无创呼吸支持以及呼吸支持的典型方面,如患者-呼吸机不同步、撤机实践和作为挽救治疗的体外支持。PRoVENT-PED纳入年龄在18岁以下、入住参与研究的重症监护病房并接受呼吸支持的患者。终点因各阶段的重点而异,但始终包括一组关键设置和通气参数以及相关结局。如适用,将研究潜在的可改变因素及其与结局的关联。初步可行性研究表明,电子采集系统能在合理的时间限制内有效收集所有必要数据,且缺失数据极少。

结论

PRoVENT-PED是一项为期10年的国际多中心研究,专注于收集危重症小儿患者呼吸支持实践的数据。其范围从有创通气支持发展到无创通气支持,最终涵盖患者-呼吸机不同步、撤机实践和挽救治疗。

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