CHEST：气管插管患者拔管前预防性使用皮质类固醇的好处！

2017-02-27 MedSci MedSci原创

在选择性拔管之前使用皮质类固醇可以防止拔管后扩张和再插管。近期，一项发表在杂志CHEST上的研究进行了系统评价，以确定哪些患者可以从选择性拔管前预防性使用皮质类固醇中受益。研究者们对2016年2月29日前PubMed，EMBASE，万方数据库，中国学术期刊网络出版数据库和Cochrane对照试验中心注册进行了检索索。研究者收集了机械通气的患者在选择性拔管之前给予全身皮质类固醇的试验，若试验评估了疗

在选择性拔管之前使用皮质类固醇可以防止拔管后扩张和再插管。

近期，一项发表在杂志CHEST上的研究进行了系统评价，以确定哪些患者可以从选择性拔管前预防性使用皮质类固醇中受益。

研究者们对2016年2月29日前PubMed，EMBASE，万方数据库，中国学术期刊网络出版数据库和Cochrane对照试验中心注册进行了检索索。研究者收集了机械通气的患者在选择性拔管之前给予全身皮质类固醇的试验，若试验评估了疗效和安全性且是对照试验均符合条件，使用DerSimonian和Laird随机效应模型合并数据。

最终确定了11项试验，涉及2472名参与者进行了分析。使用预防性皮质类固醇与拔管后气道事件[风险比（RR）0.43,95％CI 0.29-0.66]与安慰剂或无治疗相比，其与重新插管的发生率降低相关（RR 0.42，95％CI 0.25-0.71）。这种关联在拔管后气道并发症的高风险参与者中是显着的，可以减少拔管后气道事件（RR 0.34,95％CI 0.24-0.48）和再插管的发生率，（RR 0.35，95％CI 0.20-0.64）。在未经选择参与者的试验中未发现该关联。不良事件是罕见的。

此项研究得出结论：在选择性拔管之前给予预防性皮质类固醇与拔管后气道事件和重新插管的发生率显着降低相关，几乎没有不良事件发生。应合理选择可能受益于预防性使用皮质类固醇的气道阻塞高风险患者。

原始出处：
Kuriyama A, Umakoshi N, Sun R. Prophylactic corticosteroids for prevention of post-extubation stridor and reintubation in adults: a systematic review and meta-analysis. Chest. 2017 Feb 20. pii: S0012-3692(17)30228-3. doi: 10.1016/j.chest.2017.02.017.

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2017-10-31 xiangyuzhou971

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2017-10-18 Smile2680

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#类固醇#

25 0
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2017-03-01 steven_u4

#拔管#

28 0
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2017-03-01 yangfl08

#气管插管#

25 0
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2017-02-28 飛歌

下次插管的时候用一下

70 0

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CHEST：气管插管患者拔管前预防性使用皮质类固醇的好处！

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