■本研究的目的是对经鼻高流量鼻插管与其他常规氧疗装置在支气管镜检查患者中的临床应用效果进行系统评价和荟萃分析。
■在多个英文数据库中进行了全面的文献检索,包括PubMed,WebofScience,和Cochrane图书馆,收集高流量鼻插管在支气管镜检查患者中应用的相关研究,并利用RevMan5.4软件进行了荟萃分析,遵循预定的纳入和排除标准。
■共纳入12项符合纳入标准的研究,涉及1,631例患者(HFNC组:n=811,其他氧疗组:n=820)。荟萃分析结果表明,与常规氧疗相比,HFNC显着降低了低氧血症的发生率,并提高了最低氧饱和度(RR=0.27,95%CI:0.18-0.41,p<0.00001;MD=6.09,95%CI:3.73-8.45,p<0.00001)。此外,HFNC在低氧血症发生率(RR=3.52,95%CI:1.13-10.97,p=0.03)和最低氧饱和度(MD=-1.97,95%CI:-2.97-0.98,p<0.0001)方面与无创通气相比,差异具有统计学意义。此外,与常规氧疗相比,HFNC导致手术时间明显缩短,手术结束时PaO2升高(MD=1.53,95%CI:0.66-2.40,p=0.0006;MD=15.52,95%CI:10.12-20.92,p<0.00001)。然而,手术结束时,PaCO2,EtCO2和MAP无统计学差异(MD=1.23,95%CI:-0.74-3.20,p=0.22;MD=-0.35,95%CI:-3.77-3.06,p=0.84;MD=-0.54,95%CI:-2.44-1.36,p=0.58).
■当在支气管镜检查患者的检查和治疗期间使用HFNC或NIV时,与常规氧疗相比,两种氧合方式均可增强氧合功能,降低低氧血症发生率.对于接受支气管镜检查的特定高危患者,HFNC可以被视为NIV的可行替代方案。它减少了支气管镜检查的持续时间,并改善了手术结束时的PaO2水平,但不显著影响PaCO2、EtCO2和平均动脉压。
■https://www.crd.约克。AC.英国/PROSPERO/,标识符1414374462@qq.com.
UNASSIGNED: The objective of this study was to conduct a systematic review and meta-analysis of the clinical application effects of transnasal high flow nasal cannula compared to other conventional modalities for oxygen therapy devices in patients undergoing bronchoscopy.
UNASSIGNED: A comprehensive literature search was conducted in multiple English databases, including PubMed, Web of Science, and Cochrane Library, to collect relevant studies on the application of high flow nasal cannula in patients undergoing bronchoscopy, and conducted a meta-analysis utilizing RevMan 5.4 software, following the predetermined inclusion and exclusion criteria.
UNASSIGNED: A total of 12 studies meeting the inclusion criteria were included, involving 1,631 patients (HFNC group: n = 811, other oxygen therapy group: n = 820). The meta-analysis results demonstrated that HFNC significantly reduced the incidence of hypoxemia and improved the minimum oxygen saturation compared to conventional oxygen therapy (RR = 0.27, 95% CI: 0.18-0.41, p < 0.00001; MD = 6.09, 95% CI: 3.73-8.45, p < 0.00001). Furthermore, HFNC showed statistically significant differences when compared to non-invasive ventilation in terms of hypoxemia incidence (RR = 3.52, 95% CI: 1.13-10.97, p = 0.03) and minimum oxygen saturation (MD = -1.97, 95% CI: -2.97--0.98, p < 0.0001). In addition, HFNC resulted in significantly shorter surgical time and higher PaO2 at the end of the procedure compared to conventional oxygen therapy (MD = 1.53, 95% CI: 0.66-2.40, p = 0.0006; MD = 15.52, 95% CI: 10.12-20.92, p < 0.00001). However, there were no statistically significant differences observed in PaCO2, EtCO2, and MAP at the end of the procedure (MD = 1.23, 95% CI: -0.74-3.20, p = 0.22; MD = -0.35, 95% CI: -3.77-3.06, p = 0.84; MD = -0.54, 95% CI: -2.44-1.36, p = 0.58).
UNASSIGNED: When HFNC or NIV is utilized during the examination and treatment of bronchoscopy patients, both oxygenation modalities enhance oxygenation function and reduce the incidence of hypoxemia compared to conventional oxygen therapy. HFNC can be regarded as a viable alternative to NIV for specific high-risk patients undergoing bronchoscopy. It decreases the duration of bronchoscopy and improves the PaO2 levels at the end of the procedure, but does not significantly impact the PaCO2, EtCO2, and mean arterial pressure.
UNASSIGNED: https://www.crd.york.ac.uk/PROSPERO/, identifier 1414374462@qq.com.