Abstract:
Non-invasive respiratory support (NIRS) in adult, pediatric, and neonatal patients with acute respiratory failure (ARF) comprises two treatment modalities, non-invasive mechanical ventilation (NIMV) and high-flow nasal cannula (HFNC) therapy. However, experts from different specialties disagree on the benefit of these techniques in different clinical settings. The objective of this consensus was to develop a series of good clinical practice recommendations for the application of non-invasive support in patients with ARF, endorsed by all scientific societies involved in the management of adult and pediatric/neonatal patients with ARF. To this end, the different societies involved were contacted, and they in turn appointed a group of 26 professionals with sufficient experience in the use of these techniques. Three face-to-face meetings were held to agree on recommendations (up to a total of 71) based on a literature review and the latest evidence associated with 3 categories: indications, monitoring and follow-up of NIRS. Finally, the experts from each scientific society involved voted telematically on each of the recommendations. To classify the degree of agreement, an analogue classification system was chosen that was easy and intuitive to use and that clearly stated whether the each NIRS intervention should be applied, could be applied, or should not be applied.
摘要:
成人非侵入性呼吸支持(NIRS),儿科,和新生儿急性呼吸衰竭(ARF)患者包括两种治疗方式,无创机械通气(NIMV)和高流量鼻插管(HFNC)治疗。然而,来自不同专业的专家对这些技术在不同临床环境中的益处持不同意见。该共识的目的是为ARF患者的非侵入性支持应用制定一系列良好的临床实践建议。所有参与治疗成人和儿童/新生儿ARF患者的科学学会都认可。为此,联系了不同的社会,他们又任命了一组26名在使用这些技术方面有足够经验的专业人员。举行了三次面对面会议,根据文献综述和与3类相关的最新证据,就建议达成一致(总共71项):适应症,NIRS的监测和随访。最后,每个科学协会的专家都对每个建议进行了远程投票。为了对一致性程度进行分类,选择了一个模拟分类系统,该系统易于使用且直观,并且清楚地说明了是否应应用每个NIRS干预措施,可以应用,或者不应该应用。