年度综述
ENGLISH ABSTRACT
无创正压通气临床研究年度进展2024
黄巧云
查姗姗
关力理
何振锋
牛建一
陈荣昌
作者及单位信息
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DOI: 10.3760/cma.j.cn112147-20241118-00683
Clinical research progress in non-invasive positive pressure ventilation from 2023 to 2024
Huang Qiaoyun
Zha Shanshan
Guan Lili
He Zhenfeng
Niu Jianyi
Chen Rongchang
Authors Info & Affiliations
Huang Qiaoyun
State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou 510120, China
Zha Shanshan
State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou 510120, China
Guan Lili
State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou 510120, China
He Zhenfeng
State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou 510120, China
Niu Jianyi
State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou 510120, China
Chen Rongchang
State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou 510120, China
·
DOI: 10.3760/cma.j.cn112147-20241118-00683
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摘要

本综述通过Medline检索2023年10月1日至2024年9月30日期间无创正压通气(NPPV)相关临床研究的文献,系统梳理了2024年度NPPV在急性呼吸衰竭(ARF)和慢性呼吸衰竭(CRF)中应用的最新研究进展。在NPPV治疗ARF方面,通过数字孪生体实验发现过高潮气量相关的自发式肺损伤可能是导致NPPV失败的原因;NPPV期间镇静镇痛剂的使用与病死率增加相关。在慢性阻塞性肺疾病急性加重患者治疗方面,高强度NPPV可显著降低插管率;而高流量鼻导管氧疗作为初始治疗疗效劣于NPPV。在CRF患者家庭NPPV治疗方面,基于法国国家医疗保健系统数据库探索了接受家庭NPPV治疗的慢性阻塞性肺疾病患者的在启动NPPV之前的健康轨迹,提出不同情况下启动家庭NPPV治疗对预后发生影响;国内研究发现,基于物联网对家庭NPPV进行远程管理可进一步改善患者的生活质量及降低再入院风险。预防再插管方面,不同基础疾病对NPPV治疗反应不相同,预防性应用NPPV可降低肥胖患者术后、而非急性脑损伤患者的再插管风险。在NPPV技术改进方面,有学者联合储氧袋和中流量氧疗制作出简易的Bag-CPAP,可作为资源紧缺时备选通气选择。

ABSTRACT

The present review conducted a comprehensive search and retrieval of clinical studies related to non-invasive positive pressure ventilation (NPPV) for acute respiratory failure (ARF) and chronic respiratory failure (CRF) retrieved from Medline between October 1, 2023 and September 30, 2024. In the treatment of ARF with NPPV, experiments using Digital Twins had shown that excessive tidal volumes associated self-inflicted lung injury might contribute to NPPV failure. The administration of sedation and analgesia during NPPV was found to correlate with increased mortality. In patients with acute exacerbations of chronic obstructive pulmonary disease, high-intensity NPPV significantly reduced intubation rates. However, high-flow nasal cannula oxygen therapy (HFNC) was less effective than NPPV when used as an initial treatment. In the management of CRF patients, a Franch study examined the pre-NPPV health trajectory of COPD patients receiving home NPPV based on French national health insurance reimbursement system database and suggested that the timing of initiation of home NPPV treatment significantly influenced prognosis. In addition, the research found that remote management utilizing Internet of Things technology enhanced patients′ health-related quality of life and reduced the risk of hospital readmission. In terms of preventing re-intubation, different underlying conditions exhibited different responses to NPPV treatment. Specifically, prophylactic use of NPPV was found to reduce the risk of reintubation in obese surgical patients, but not in those with acute brain injury. In terms of technological advancements, Bag-CPAP, a device consisting of an oxygen storage bag and medium flow oxygen, has been validated as an alternative ventilation choice suitable for resource-limited settings.

Chen Rongchang, Email: mocdef.3ab61.pivcrnehc
引用本文

黄巧云,查姗姗,关力理,等. 无创正压通气临床研究年度进展2024[J]. 中华结核和呼吸杂志,2025,48(02):154-158.

DOI:10.3760/cma.j.cn112147-20241118-00683

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无创正压通气(non-invasive positive pressure ventilation,NPPV)作为一种安全且有效的呼吸支持技术,被广泛应用于各种呼吸疾病和临床场景。为了解NPPV在本年度的研究进展,本文通过Medline检索2023年10月1日至2024年 9月30日期间NPPV相关临床研究的文献并进行综述,包括NPPV治疗急性呼吸衰竭(acute respiratory failure,ARF)、慢性呼吸衰竭(chronic respiratory failure,CRF)、NPPV预防再插管及技术改进等内容。
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备注信息
A
陈荣昌,Email: mocdef.3ab61.pivcrnehc
B
黄巧云, 查姗姗, 关力理, 等. 无创正压通气临床研究年度进展2024[J]. 中华结核和呼吸杂志, 2025, 48(2): 154-158. DOI: 10.3760/cma.j.cn112147-20241118-00683.
C
所有作者声明无利益冲突
D
国家重点研发计划 (2022YFF0710802)
国家自然科学基金 (82200046)
深圳市科技计划项目 (KCXFZ202002011008256)
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