高流量鼻插管(HFNC)是一种相对较新的呼吸支持技术,可提供高流量,加热和加湿控制浓度的氧气通过鼻途径。最近,它的使用增加了各种临床适应症。指导临床实践,我们制定了关于在各种临床环境中使用HFNC的循证建议.
我们成立了一个由临床医生组成的指导小组,方法学家和呼吸医学专家。使用等级,小组就四个可采取行动的问题提出了建议。
与常规氧疗(COT)相比,指南小组强烈建议HFNC治疗低氧性呼吸衰竭(中度确定性),拔管后HFNC的有条件建议(中度确定性),没有关于气管插管期间HFNC的建议(中度确定性),对心脏或胸部手术后的高危和/或肥胖患者进行术后HFNC的有条件建议(中度确定性)。
本临床实践指南将目前的最佳证据综合为低氧性呼吸衰竭患者使用HFNC的四项建议。拔管后,在围插管期,以及床旁临床医生的术后。
High flow nasal cannula (HFNC) is a relatively recent respiratory support technique which delivers high flow, heated and humidified controlled concentration of oxygen via the nasal route. Recently, its use has increased for a variety of clinical indications. To guide clinical practice, we developed evidence-based recommendations regarding use of HFNC in various clinical settings.
We formed a
guideline panel composed of clinicians, methodologists and experts in respiratory medicine. Using GRADE, the panel developed recommendations for four actionable questions.
The
guideline panel made a strong recommendation for HFNC in hypoxemic respiratory failure compared to conventional oxygen therapy (COT) (moderate certainty), a conditional recommendation for HFNC following
extubation (moderate certainty), no recommendation regarding HFNC in the peri-intubation period (moderate certainty), and a conditional recommendation for postoperative HFNC in high risk and/or obese patients following cardiac or thoracic surgery (moderate certainty).
This clinical practice
guideline synthesizes current best-evidence into four recommendations for HFNC use in patients with hypoxemic respiratory failure, following
extubation, in the peri-intubation period, and postoperatively for bedside clinicians.