机械通气患者临床应用机械吸-呼技术专家建议(2024)

Expert recommendations on the clinical application of mechanical insufflation-exsufflation in mechanically ventilated patients(2024)

机械通气患者是咳嗽能力受损的高发群体,需采取相应的医疗技术进行咳嗽辅助,以便清除气道分泌物。机械吸-呼技术(MI-E)在神经肌肉疾病导致的咳嗽无力患者中得到广泛应用,但是对于保留人工气道的机械通气患者,目前尚缺乏规范的应用流程,进而影响到治疗效果。由中国病理生理学会危重病医学专业委员会等发起,组织重症医师、护士、呼吸治疗师等专家聚焦MI-E在机械通气患者中的临床应用,经过系统检索、提取及汇总国内外循证医学证据及临床经验,提出建议,并通过改良德尔菲法形成《机械通气患者临床应用机械吸-呼技术专家建议(2024)》,为科学规范地应用该技术提供参考。同时,本专家建议也将为今后开展机械通气患者应用MI-E的临床研究提供借鉴。

Mechanical ventilated patients are a high-risk group with impaired cough ability and require corresponding medical techniques for cough assistance to clear airway secretions.Mechanical insufflation-exsufflation(MI-E)technology is widely used in patients with cough weakness caused by neuromuscular diseases.However,there is currently a lack of standardized application procedures for mechanically ventilated patients who retain artificial airways,which can affect treatment outcomes.Chinese Society of Critical Care Medicine organized experts including critical care physicians,nurses,respiratory therapists that focused on the clinical application of mechanical insufflation-exsufflation in mechanically ventilated patients.Through systematic collection,extraction,and summary of evidence-based clinical practice evidence and clinical experience,suggestions are proposed.Expert recommendations on the clinical application of mechanical insufflation-exsufflation in mechanically ventilated patients(2024)was formed by using improved Delphi method,hoping to provide references for standardized application of this technology.At the same time,those recommendations will also provide a reference for future clinical research on the application of mechanical insufflation-exsufflation technology in mechanically ventilated patients.