PDF(Pubmed)
Abstract：
OBJECTIVE: Patients with acute respiratory failure often require mechanical ventilation to reduce the work of breathing and improve gas exchange; however, this may exacerbate lung injury. Protective ventilation strategies, characterized by low tidal volumes (≤ 8mL/kg of predicted body weight) and limited plateau pressure below 30cmH2O, have shown improved outcomes in patients with acute respiratory distress syndrome. However, in the transition to spontaneous ventilation, it can be challenging to maintain tidal volume within protective levels, and it is unclear whether low tidal volumes during spontaneous ventilation impact patient outcomes. We developed a study protocol to estimate the prevalence of low tidal volume ventilation in the first 24 hours of spontaneous ventilation in patients with hypoxemic acute respiratory failure and its association with ventilator-free days and survival.
METHODS: We designed a multicenter, multinational, cohort study with a 28-day follow-up that will include patients with acute respiratory failure, defined as a partial oxygen pressure/fraction of inspired oxygen ratio < 300mmHg, in transition to spontaneous ventilation in intensive care units in Latin America.
RESULTS: We plan to include 422 patients in ten countries. The primary outcomes are the prevalence of low tidal volume in the first 24 hours of spontaneous ventilation and ventilator-free days on day 28. The secondary outcomes are intensive care unit and hospital mortality, incidence of asynchrony and return to controlled ventilation and sedation.
CONCLUSIONS: In this study, we will assess the prevalence of low tidal volume during spontaneous ventilation and its association with clinical outcomes, which can inform clinical practice and future clinical trials.
METHODS: We designed a multicenter, multinational, cohort study with a 28-day follow-up that will include patients with acute respiratory failure, defined as a partial oxygen pressure/fraction of inspired oxygen ratio < 300mmHg, in transition to spontaneous ventilation in intensive care units in Latin America.
RESULTS: We plan to include 422 patients in ten countries. The primary outcomes are the prevalence of low tidal volume in the first 24 hours of spontaneous ventilation and ventilator-free days on day 28. The secondary outcomes are intensive care unit and hospital mortality, incidence of asynchrony and return to controlled ventilation and sedation.
CONCLUSIONS: In this study, we will assess the prevalence of low tidal volume during spontaneous ventilation and its association with clinical outcomes, which can inform clinical practice and future clinical trials.
摘要：
目的：急性呼吸衰竭患者通常需要机械通气以减少呼吸功并改善气体交换；但是，这可能会加剧肺损伤。保护性通风策略，以低潮气量（≤8mL/kg预测体重）和低于30cmH2O的有限平台压力为特征，已显示改善急性呼吸窘迫综合征患者的预后。然而,在向自发通风的过渡中，将潮气量保持在保护水平内可能具有挑战性，目前尚不清楚自主通气期间的低潮气量是否会影响患者的预后。我们制定了一项研究方案，以评估低氧性急性呼吸衰竭患者在自发通气的前24小时内低潮气量通气的患病率及其与无呼吸机天数和生存率的关系。
方法：我们设计了一个多中心，跨国公司,28天随访的队列研究将包括急性呼吸衰竭患者，定义为氧分压/吸入氧比分数<300mmHg，拉丁美洲重症监护病房向自发通气过渡。
结果：我们计划纳入10个国家的422名患者。主要结果是自发通气的前24小时和第28天的无呼吸机日的低潮气量患病率。次要结果是重症监护病房和医院死亡率，不同步和恢复受控通气和镇静的发生率。
结论：在这项研究中，我们将评估自主通气期间低潮气量的患病率及其与临床结果的关系，这可以为临床实践和未来的临床试验提供信息。
方法：我们设计了一个多中心，跨国公司,28天随访的队列研究将包括急性呼吸衰竭患者，定义为氧分压/吸入氧比分数<300mmHg，拉丁美洲重症监护病房向自发通气过渡。
结果：我们计划纳入10个国家的422名患者。主要结果是自发通气的前24小时和第28天的无呼吸机日的低潮气量患病率。次要结果是重症监护病房和医院死亡率，不同步和恢复受控通气和镇静的发生率。
结论：在这项研究中，我们将评估自主通气期间低潮气量的患病率及其与临床结果的关系，这可以为临床实践和未来的临床试验提供信息。
