医学
四分位间距
排气
机械通风
重症监护室
痰
随机对照试验
麻醉
临床终点
优势比
自主呼吸试验
吹气
内科学
肺结核
病理
作者
Sachio Kubota,Hideki Hashimoto,Yurika Yoshikawa,K Hiwatashi,Takahiro Ono,Masaki Mochizuki,Hiromu Naraba,Hidehiko Nakano,Yūji Takahashi,Tomohiro Sonoo,Kensuke Nakamura
出处
期刊:PLOS ONE
[Public Library of Science]
日期:2024-05-02
卷期号:19 (5): e0302239-e0302239
被引量:1
标识
DOI:10.1371/journal.pone.0302239
摘要
Background Mechanical insufflation-exsufflation (MI-E) facilitates extubation. However, its potential to reduce the duration of ventilator use remains unclear. Therefore, the present study investigated whether the use of MI-E shortened the duration of mechanical ventilation in patients with high sputum retention. Methods A randomized open-label trial was conducted at a single intensive care unit (ICU) in Japan between November 2017 and June 2019. Ventilated subjects requiring suctioning at least once every hour due to sputum retention were randomly assigned to the MI-E group or conventional care group. The primary endpoint was the number of ventilator-free days on day 28. Secondary endpoints were ventilator days in surviving subjects, the length of ICU stay, and mortality and tracheostomy rates among survivors. Results Forty-eight subjects (81% males) with a median age of 72 years (interquartile range [IQR], 65–85 years) were enrolled. There were 27 subjects in the MI-E group and 21 in the control group. The median number of ventilator-free days was 21 (IQR, 13–24) and 18, respectively (IQR, 0–23) (P = .38). No significant differences were observed in the ICU length of stay (median, 10 days (IQR, 7–12) vs 12 days (IQR, 6–15); P = .31), mortality rate (19% vs 15%; odds ratio [OR], 1.36 [0.28–6.50]; P = .69), or tracheostomy rate among survivors (14% vs 28%; OR, 0.40 [0.08–1.91]; P = .25). Conclusion In ventilated subjects in the ICU with high sputum retention, the use of MI-E did not significantly increase the number of ventilator-free days over that with conventional care.
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