Effect of Continuous High-Frequency Oscillation Therapy on Lung Aeration in Mechanically Ventilated Patients With Impaired Consciousness: A Multicenter Randomized Controlled Trial.

It is mainly caused by secretion accumulation, which can lead to longer durations of ventilation and ICU stay.

它主要是由于分泌物积聚引起的，这可能导致通气和ICU住院时间延长。

research_question

Does continuous high-frequency oscillation (CHFO) therapy improve lung aeration and reduce atelectasis in adults with impaired consciousness who are mechanically ventilated?

持续高频振荡（CHFO）疗法是否能改善意识受损成人的机械通气患者的肺泡通气并减少肺不张？

study_design_and_methods

This multicenter, single-anonymized, randomized controlled trialwas conducted across 11 hospitals in China.

这项多中心、单盲、随机对照试验在中国的11家医院进行。

Adult patients with impaired consciousness (Glasgow Coma Scale score ≤ 8) who required invasive mechanical ventilation were randomly assigned in a 1:1 ratio to either the CHFO or usual care group.

需要侵入性机械通气的成人意识障碍患者（格拉斯哥昏迷评分≤8）按1:1的比例随机分配到CHFO组或常规护理组。

The CHFO group received 3 to 4 sessions daily.

CHFO组每天接受3到4次治疗。

The primary outcome was the percent change in nonaerated lung tissue, measured by CT scan, from baseline to day 5, as analyzed in the intention-to-treatpopulation.

主要结果是从基线到第5天非气化肺组织的百分比变化，通过CT扫描测量，并在意向治疗人群中进行了分析。

Results

From June 19, 2023, to July 2, 2024, a total of 80 patients were included in the intention-to-treatanalysis.

从2023年6月19日至2024年7月2日，意向治疗分析共纳入了80名患者。

Five patients from each group were excluded from the primary analysis due to incomplete CT scans.

由于CT扫描不完整，每组各有五名患者被排除在主要分析之外。

On day 5, the decrease in nonaerated lung tissue was greater in the CHFO group (-51.3%; 95% CI, -62.7 to -40.0) compared with the usual care group (-37.6%; 95% CI, -49.3 to -26.0), with a mean difference of -13.69% (95% CI, -24.86 to -2.52; P = .017).

在第5天，与常规护理组相比（-37.6%；95%置信区间，-49.3至-26.0），CHFO组的非通气肺组织减少更多（-51.3%；95%置信区间，-62.7至-40.0），平均差异为-13.69%（95%置信区间，-24.86至-2.52；P = .017）。

The CHFO group also had a higher number of ventilator-free days, a lower clinical pulmonary infection score, and a shorter ICU stay.

CHFO组还拥有更多的无呼吸机天数，更低的临床肺部感染评分，以及更短的ICU住院时间。

No adverse events of interest were observed during the study.

研究期间未观察到感兴趣的不良事件。

interpretation

In patients with impaired consciousness who are mechanically ventilated, 5 days of CHFO treatment was shown to significantly reduce nonaerated lung tissue.

在机械通气的意识障碍患者中，5天的连续高频振荡（CHFO）治疗被证明可以显著减少非通气肺组织。

clinical_trial_registration

Chinese Clinical Trial Registry; No.: ChiCTR2300070988; https://www.chictr.org.cn.

中国临床试验注册中心；注册号：ChiCTR2300070988；网址：https://www.chictr.org.cn。