文献

J-GLOBAL ID：202202231918117004   整理番号：22A0621239

重症成人における抜管後の非侵襲的呼吸支援:系統的レビューとネットワークメタ分析【JST・京大機械翻訳】

Noninvasive respiratory support following extubation in critically ill adults: a systematic review and network meta-analysis

著者 (52件)： Fernando Shannon M. (Division of Critical Care, Department of Medicine, University of Ottawa, Ottawa, ON, Canada) ,  Fernando Shannon M. (Department of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada) ,  Tran Alexandre (Division of Critical Care, Department of Medicine, University of Ottawa, Ottawa, ON, Canada) ,  Tran Alexandre (Department of Surgery, University of Ottawa, Ottawa, ON, Canada) ,  Tran Alexandre (School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada) ,  Sadeghirad Behnam (Department of Anesthesia, McMaster University, Hamilton, ON, Canada) ,  Sadeghirad Behnam (Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada) ,  Burns Karen E. A. (Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada) ,  Burns Karen E. A. (Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada) ,  Burns Karen E. A. (Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON, Canada) ,  Fan Eddy (Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada) ,  Fan Eddy (Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada) ,  Fan Eddy (Department of Medicine, Sinai Health System and University Health Network, Toronto, ON, Canada) ,  Fan Eddy (Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada) ,  Brodie Daniel (Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA) ,  Brodie Daniel (Center for Acute Respiratory Failure, New York-Presbyterian Hospital, New York, NY, USA) ,  Munshi Laveena (Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada) ,  Munshi Laveena (Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada) ,  Munshi Laveena (Department of Medicine, Sinai Health System and University Health Network, Toronto, ON, Canada) ,  Goligher Ewan C. (Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada) ,  Goligher Ewan C. (Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada) ,  Goligher Ewan C. (Department of Medicine, Sinai Health System and University Health Network, Toronto, ON, Canada) ,  Goligher Ewan C. (Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada) ,  Cook Deborah J. (Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada) ,  Cook Deborah J. (Department of Medicine, Division of Critical Care, McMaster University, Hamilton, ON, Canada) ,  Fowler Robert A. (Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada) ,  Fowler Robert A. (Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada) ,  Fowler Robert A. (Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada) ,  Herridge Margaret S. (Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada) ,  Herridge Margaret S. (Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada) ,  Herridge Margaret S. (Department of Medicine, Sinai Health System and University Health Network, Toronto, ON, Canada) ,  Herridge Margaret S. (Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada) ,  Cardinal Pierre (Division of Critical Care, Department of Medicine, University of Ottawa, Ottawa, ON, Canada) ,  Jaber Samir (Hopital Saint-Eloi, Centre Hospitalier Universitaire (CHU) Montpellier, PhyMedExp, INSERM, CNRS, Montpellier, France) ,  Jaber Samir (Departement de Medecine Intensive et Reanimation, Centre Hospitalier Universitaire (CHU) Montpellier, PhyMedExp, INSERM, CNRS, Montpellier, France) ,  Moller Morten Hylander (Department of Intensive Care, Copenhagen University Righospitalet, Copenhagen, Denmark) ,  Thille Arnaud W. (Centre Hospitalier Universitaire de Poitiers, Medecine Intensive Reanimation, Poitiers, France) ,  Thille Arnaud W. (INSERM Centre d’Investigation Clinique 1402, ALIVE, Universite de Poitiers, Poitiers, France) ,  Ferguson Niall D. (Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada) ,  Ferguson Niall D. (Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada) ,  Ferguson Niall D. (Department of Medicine, Sinai Health System and University Health Network, Toronto, ON, Canada) ,  Ferguson Niall D. (Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada) ,  Slutsky Arthur S. (Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada) ,  Slutsky Arthur S. (Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON, Canada) ,  Brochard Laurent J. (Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada) ,  Brochard Laurent J. (Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON, Canada) ,  Seely Andrew J. E. (Division of Critical Care, Department of Medicine, University of Ottawa, Ottawa, ON, Canada) ,  Seely Andrew J. E. (Department of Surgery, University of Ottawa, Ottawa, ON, Canada) ,  Seely Andrew J. E. (School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada) ,  Seely Andrew J. E. (Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada) ,  Rochwerg Bram (Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada) ,  Rochwerg Bram (Department of Medicine, Division of Critical Care, McMaster University, Hamilton, ON, Canada)
資料名： Intensive Care Medicine  (Intensive Care Medicine)
巻： 48  号： 2  ページ： 137-147  発行年： 2022年 
JST資料番号： T0102A  ISSN： 0342-4642  資料種別： 逐次刊行物 (A)
記事区分： 文献レビュー  発行国： ドイツ (DEU)  言語： 英語 (EN)

抄録/ポイント： 目的:重症成人の抜管障害の低減において,非侵襲的陽圧換気(NIPPV)と高流量鼻カニューレ(HFNC)を含む非侵襲的呼吸戦略の有効性を検討するための系統的レビューとネットワークメタ分析。方法:重症成人の抜管後,非侵襲的呼吸支持療法(NIPPV,HFNC,従来の酸素療法,またはこれらの併用)を評価する無作為化比較試験(RCT)のために,2021年10月~2021日までのデータベースを検索した。2人のレビュー者は,スクリーニング,完全なテキストレビューおよび抽出を独立して行った。関心の一次転帰は再挿管であった。著者らは,著者らの所見の確実性にGRADEを使用した。結果:著者らは36のRCT(6806人の患者)を含んだ。従来の酸素療法と比較して,NIPPV(OR 0.65[95%CI 0.52~0.82)]とHFNC(OR0.63[95%CI 0.45~0.87])は再挿管(中等度確実性)を減少させた。感度解析は,効果の大きさが再挿管のベースラインリスク増加患者で最も高いことを示した。HFNCと比較して,再挿管の発生率はNIPPVでは見られなかった(OR 1.04[95%CI 0.78~1.38],低い確実性)。従来の酸素療法と比較して,NIPPV(OR 0.8[95%CI 0.61~1.04],中等度確実性)またはHFNC(OR 0.9[95%CI 0.66~1.24],低い確実性)は短期死亡率を減少させた。一貫した所見は,高リスクおよび低リスク患者を含む複数のサブグループにわたって示された。これらの結果は,予防のための非侵襲的戦略(予防)を評価する際に複製されたが,救出(悪化のエビデンス後のみ)状況はそうではなかった。結論:著者らの知見は,NIPPVとHFNCの両方が,従来の酸素療法と比較して,重症成人における再挿管を減少させることを示唆する。NIPPVはHFNCと比較して再挿管の発生率を低下させなかった。これらの知見は,重症成人における抜管障害を緩和するための非侵襲的呼吸支援戦略の防止的適用を支持するが,救出条件ではそうではない。Copyright Springer-Verlag GmbH Germany, part of Springer Nature 2021 Translated from English into Japanese by JST.【JST・京大機械翻訳】

シソーラス用語： データベース ,  流量 ,  換気 ,  感度解析 ,  死亡率 ,  成人 ,  予防 ,  スクリーニング ,  酸素療法 ,  気管内挿管 ,  ランダム化比較試験 ,  *システマティックレビュー
準シソーラス用語： NPPV ,  *非侵襲 ,  確実性 ,  再挿管 , 【Automatic Indexing@JST】

著者キーワード (4件)： 救命救急医学 ,  機械的換気 ,  抜管不全 ,  高流量鼻カニューレ

分類 (1件)： 呼吸器疾患の治療一般  (GI05010Y)

タイトルに関連する用語 (8件)： 重症 ,  成人 ,  抜管 ,  非侵襲的 ,  呼吸 ,  支援 ,  系統的レビュー ,  ネットワークメタ分析