新指南推荐丨2016正式美国胸科学会/美国胸科医师学院临床实践指南：解放危重病患者的机械通气

 

2016正式美国胸科学会/美国胸科医师学院临床实践指南：解放危重病患者的机械通气

2016 An Official American Thoracic Society/American College of Chest Physicians Clinical Practice Guideline: Liberation from Mechanical Ventilation in Critically Ill Adults

推荐医者： 浙江医院 

ICU 蔡国龙

制定者：

美国胸科学会（ATS）

美国胸科医师学院（ACCP）

内容介绍

Background

Interventions that lead to earlier liberation from mechanical ventilation can improve patient outcomes.This guideline,a collaborative effort between the American Thoracic Society (ATS) and the American College of Chest Physicians (CHEST),provides evidence-based recommendations to optimize liberation from mechanical ventilation in critically ill adults.

Methods

Two methodologists performed evidence syntheses to summarize available evidence relevant to key questions about liberation from mechanical ventilation.The methodologists appraised the certainty in the evidence (i.e.,the quality of evidence) using the Grading of Recommendations,Assessment,Development,and Evaluation (GRADE) approach and summarized the results in evidence profiles.The guideline panel then formulated recommendations after considering the balance of desirable consequences (benefits) versus undesirable consequences (burdens,adverse effects,and costs),the certainty in the evidence,and the feasibility and acceptability of various interventions.Recommendations were rated as strong or conditional.

Results

The guideline panel made four conditional recommendations related to rehabilitation protocols,ventilator liberation protocols,and cuff leak tests.The recommendations were for acutely hospitalized adults mechanically ventilated for >24 hours to receive protocolized rehabilitation directed toward early mobilization; be managed with a ventilator liberation protocol; be assessed with a cuff leak test if they meet extubation criteria but are deemed high risk for post-extubation stridor; and be administered systemic steroids for at least 4 hours before extubation if they fail the cuff leak test.

Conclusion

The ATS/CHEST recommendations are intended to support healthcare professionals in their decisions related to liberating critically ill adults from mechanical ventilation.

医者摄影作品展

赛里木湖-楼林-浙江省人民医院-神经外科

温宿的峡谷-楼林-浙江省人民医院-神经外科