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首页> 外文期刊>The Open Anesthesia Journal >Use of Either Non-invasive Ventilation Immediately Post-extubation or Controlled Mechanical Ventilation for One Hour after Fulfilling Weaning Criteria Decreases Re-intubation of Patients with Post-traumatic ARDS
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Use of Either Non-invasive Ventilation Immediately Post-extubation or Controlled Mechanical Ventilation for One Hour after Fulfilling Weaning Criteria Decreases Re-intubation of Patients with Post-traumatic ARDS

机译：在满足断奶标准后立即使用非侵入式通风1小时后立即使用拔下后或控制的机械通气1小时减少了创伤后患者的重新插管

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Introduction:Re-intubation and re-ventilation after complete weaning of patients with prolonged ventilation are considered a major problem in ICU. The re-intubation in such patients associated with higher mortalities prolongs the duration of ICU stay. The mortality rate in those patients may exceed 40% in some studies.Aims:The study aimed to compare and evaluate the effect of use of two new maneuvers with control after fulfilling criteria of weaning from prolonged ventilation, either immediate use of NIV post-extubation and every 12 hours for 24 hours or MV for one hour on both re-intubation and ICU discharge of traumatic ARDS patients who ventilated for one week or more.Materials and Methods:It is a prospective double-blind study done on total 300 patients, admitted with respiratory failure ARDS due to severe lung contusion. All of them were selected to be ventilated for > one week. All of them fulfilled the criteria of weaning at the end of the studied period. Patients were randomly allocated in three groups; each group contained 100 patients. Group A was considered the control group. They extubated and followed our routine protocol; patients of group B used our first new maneuver and reconnected to mechanical ventilation before extubation for one hour, while patients of group C used our second new maneuver; patients of this group extubated and immediately connected to NIV with BIPAP mode for 1 hour every 12 hours for 24 hours.Results:There was a significant reduction in the number of patients who experienced deterioration in conscious level throughout the study in patients of both groups B and C compared to group A. Also, a significant reduction was seen in the number of patients who experienced deterioration in clinical parameters of respiration, of both groups B and C compared to group A with regard to high respiratory rate, desaturation and development of hyperdynamic circulation (tachycardia and hypertension). Also, a significant reduction was seen in the number of patients who had multiple quadrant parenchymatous infiltration throughout the study in patients of both groups B and C compared to group A. significant reduction in the number of patients marked limitation to FEV1, FVC and MVV in patients of both groups B and C compared to group A.Conclusion:Use of either immediate NIV every 12 hours for 24 hours or MV for one hour after fulfillment of weaning criteria reduced reintubation, re-ventilation and post-extubation respiratory failure and decreased the ICU stay in prolonged ventilated patients due to ARDS from severe lung trauma with no significant difference between them.
机译：简介：在延长通风患者的完全断奶后重新插管和再通风被认为是ICU的一个主要问题。与更高的死亡率相关的患者的重新插管延长了ICU持续时间的持续时间。这些患者的死亡率可能超过一些研究中的40％。该研究旨在比较和评估在延长通风后弥补断奶的标准后，使用两种新的机会使用的使用效果，立即使用NIV后拔除后使用NIV每12小时24小时或mV均为重新插管和ICU排放的一次持续一周或更长的创伤性ARDS患者的一次或更多的单一小时。关于300例患者的预期双盲研究是一项预期的双盲研究，由于严重的肺部挫伤，呼吸衰竭ARDS承认。所有这些都被选为通风>一周。所有这些都满足了研究期末断奶的标准。患者在三组随机分配;每组含有100名患者。 A组被认为是对照组。他们拔管并遵循我们的常规协议; B组患者使用我们的第一个新机动并在拔管前重新连接到机械通风一小时，而C组患者使用我们的第二次新机动;该组的患者拔管并立即用BiPAP模式连接到NIV，每12小时每12小时连接1小时，持续24小时。结果显着减少了在B组患者的研究中经历了有意识级别的患者的数量与A组相比。此外，在呼吸呼吸临床参数劣化的患者的数量上，与对a的高呼吸率，除霜和开发的高呼吸速率循环（心动过速和高血压）。此外，在B和C组患者的患者与A组患者中具有多种象限的实质浸润的患者的数量，视显着减少了显着的减少。患者数量显着降低了对FEV1，FVC和MVV的限制B和C组患者与A组相比。结论：在满足断奶标准的情况下，每12小时或MV每12小时使用每12小时一次，减少重新涂布，再通风和后拔后呼吸衰竭并降低ICU由于来自严重肺创伤的ARDS而延长通风患者，它们之间没有显着差异。

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