闭环氧气验证医护人员干预在 SARS-CoV-2 肺炎 (COVID-19) 期间减少
自动氧气滴定 - 需要氧气的传染性肺炎患者的监测和脱机 - 对医护人员干预次数的影响。一种管理 COVID-19 肺炎患者的创新设备 COVID 研究(闭环氧气以验证医护人员干预减少了肺炎)
将 COVID-19 传播给医护人员的风险很高。 在最近的一个队列中,29% 的住院患者是医护人员。 在世卫组织应对 COVID-19 的主要战略目标中,第一个是限制人与人之间的传播,包括减少密切接触者和医护人员之间的继发感染。
自动氧气滴定、脱机和监测(FreeO2 设备)可能是减少医护人员与氧气治疗相关的干预次数、减少与氧气相关的并发症并改善监测的解决方案。
研究概览
研究类型
注册 (预期的)
阶段
- 不适用
联系人和位置
学习地点
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Quebec、加拿大、G1V4G5
- 招聘中
- Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
纳入标准:
- 年龄>18岁
- 与疑似社区获得性肺炎(病毒性和非病毒性)相关的急性呼吸衰竭患者,需要氧疗 < 6 L/min(或 FiO2 < 0.50)(以将 SpO2 维持在 90% 至 94% SpO2 之间),没有立即插管或 ICU 转移的标准.
- 患者入院时间 < 72 小时
排除标准:
- 休克状态,
- 没有可用的 SpO2 信号,
- 耐心躁动,
- pH < 7.30(如果有血气)
- PaCO2 > 50 mmHg,(如果有血气)或慢性高碳酸血症病史
- 纳入研究时进行无创呼吸支持(NIV、高流量鼻腔治疗 (HFNT))
- 撤除生命支持或姑息治疗作为治疗目标
- 患者或近亲拒绝参加研究
学习计划
研究是如何设计的?
设计细节
- 主要用途:其他
- 分配:随机化
- 介入模型:平行线
- 屏蔽:没有任何
武器和干预
参与者组/臂 |
干预/治疗 |
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ACTIVE_COMPARATOR:控制组
将为患者提供有关其医疗管理的常规护理。 在对照组中,通常按照当地惯例输送氧气 |
研究者建议 SpO2 目标为 90-94%。 如果使用连续血氧仪,研究者将建议将低/高 SpO2 警报设置为 88% 和 96%。 在这个组中,随时使用 FreeO2 设备记录 SpO2 - 记录模式 |
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实验性的:干预组
将为患者提供有关其医疗管理的常规护理。 在干预组中,将使用 FreeO2 提供自动供氧 |
在该组中,氧气管理将通过 FreeO2(自动氧气滴定)进行,SpO2 目标设置为 92%(以维持建议的 SpO2 目标中的氧合作用:90-94%)
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研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
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干预次数
大体时间:0 点到 4 点
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医护人员在 4 小时内管理氧疗(滴定、撤机和监测)所需的干预次数
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0 点到 4 点
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干预持续时间
大体时间:0 点到 24 点
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医护人员在 4 小时内管理氧疗(滴定、撤机和监测)所需的干预次数
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0 点到 24 点
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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平均氧流量
大体时间:0 时至 24 时(1 天)
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研究期间的平均氧气流量以评估耗氧量
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0 时至 24 时(1 天)
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SpO2 目标内的时间
大体时间:0 时至 24 时(1 天)
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SpO2 在 90% 到 94% 之间的时间
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0 时至 24 时(1 天)
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低氧血症时间
大体时间:0 时至 24 时(1 天)
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SpO2 < 88% 内的时间
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0 时至 24 时(1 天)
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高氧血症时间
大体时间:0 时至 24 时(1 天)
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SpO2 > 96% 内的时间
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0 时至 24 时(1 天)
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ICU入院率
大体时间:0 时至 24 时(1 天)
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ICU入院率
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0 时至 24 时(1 天)
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所需无创呼吸支持率
大体时间:0 时至 24 时(1 天)
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所需无创呼吸支持率 无创通气或高流量鼻腔治疗
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0 时至 24 时(1 天)
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插管率
大体时间:0 时至 24 时(1 天)
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插管率
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0 时至 24 时(1 天)
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NEWS 2分数演变
大体时间:0 时至 24 时(1 天)
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评估 NEWS 2 评分演变(国家早期预警评分)与患者演变相关。 将计算 NEWS2 分数,但不会根据该分数进行任何干预。 将在 NEWS 2 解释中比较患者的演变。 解释 低分 (NEWS 1-4) 应促使合格的注册护士进行评估,由其决定是否需要改变临床监测频率或升级临床护理。 中等分数(即 NEWS 5-6 或 RED 分数)应考虑是否需要将护理升级到具有重症监护技能的团队(即重症监护外展团队)。 高分(NEWS ≥7)应促使具有重症监护能力的临床团队/重症监护外展团队进行紧急评估,通常会将患者转移到更高的依赖性护理区。 |
0 时至 24 时(1 天)
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EWSO2分数演变
大体时间:0 时至 24 时(1 天)
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EWSO2评分(Early Warning ScoreO2)进化与患者进化相关的评估 将计算 EWSO2 分数,但不会根据该分数进行干预。 将在 EWSO2 解释中比较患者的演变。 解释 评分 <5.3 的患者的良好临床结果 得分 >18.6 的患者将经历较差的结果。 |
0 时至 24 时(1 天)
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成本效益
大体时间:从随机分组之日到出院之日
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成本效益比(每 SpO2 单位的成本)
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从随机分组之日到出院之日
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停留时间
大体时间:最多 90 天。住院 - 入院至出院或直至死亡(如果发生)
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住院时间
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最多 90 天。住院 - 入院至出院或直至死亡(如果发生)
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合作者和调查者
调查人员
- 首席研究员:Francois Lellouche、IUCPQ-UL
出版物和有用的链接
一般刊物
- Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X, Cheng Z, Yu T, Xia J, Wei Y, Wu W, Xie X, Yin W, Li H, Liu M, Xiao Y, Gao H, Guo L, Xie J, Wang G, Jiang R, Gao Z, Jin Q, Wang J, Cao B. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020 Feb 15;395(10223):497-506. doi: 10.1016/S0140-6736(20)30183-5. Epub 2020 Jan 24. Erratum In: Lancet. 2020 Jan 30;:
- Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, Wang B, Xiang H, Cheng Z, Xiong Y, Zhao Y, Li Y, Wang X, Peng Z. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020 Mar 17;323(11):1061-1069. doi: 10.1001/jama.2020.1585. Erratum In: JAMA. 2021 Mar 16;325(11):1113.
- Chu DK, Kim LH, Young PJ, Zamiri N, Almenawer SA, Jaeschke R, Szczeklik W, Schunemann HJ, Neary JD, Alhazzani W. Mortality and morbidity in acutely ill adults treated with liberal versus conservative oxygen therapy (IOTA): a systematic review and meta-analysis. Lancet. 2018 Apr 28;391(10131):1693-1705. doi: 10.1016/S0140-6736(18)30479-3. Epub 2018 Apr 26.
- Siemieniuk RAC, Chu DK, Kim LH, Guell-Rous MR, Alhazzani W, Soccal PM, Karanicolas PJ, Farhoumand PD, Siemieniuk JLK, Satia I, Irusen EM, Refaat MM, Mikita JS, Smith M, Cohen DN, Vandvik PO, Agoritsas T, Lytvyn L, Guyatt GH. Oxygen therapy for acutely ill medical patients: a clinical practice guideline. BMJ. 2018 Oct 24;363:k4169. doi: 10.1136/bmj.k4169. No abstract available.
- Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, Qiu Y, Wang J, Liu Y, Wei Y, Xia J, Yu T, Zhang X, Zhang L. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020 Feb 15;395(10223):507-513. doi: 10.1016/S0140-6736(20)30211-7. Epub 2020 Jan 30.
- L'Her E, Dias P, Gouillou M, Riou A, Souquiere L, Paleiron N, Archambault P, Bouchard PA, Lellouche F. Automatic versus manual oxygen administration in the emergency department. Eur Respir J. 2017 Jul 20;50(1):1602552. doi: 10.1183/13993003.02552-2016. Print 2017 Jul.
- Lellouche F, Bouchard PA, Roberge M, Simard S, L'Her E, Maltais F, Lacasse Y. Automated oxygen titration and weaning with FreeO2 in patients with acute exacerbation of COPD: a pilot randomized trial. Int J Chron Obstruct Pulmon Dis. 2016 Aug 24;11:1983-90. doi: 10.2147/COPD.S112820. eCollection 2016.
- Lellouche F, L'Her E, Bouchard PA, Brouillard C, Maltais F. Automatic Oxygen Titration During Walking in Subjects With COPD: A Randomized Crossover Controlled Study. Respir Care. 2016 Nov;61(11):1456-1464. doi: 10.4187/respcare.04406. Epub 2016 Oct 18.
- Arabi YM, Balkhy HH, Hayden FG, Bouchama A, Luke T, Baillie JK, Al-Omari A, Hajeer AH, Senga M, Denison MR, Nguyen-Van-Tam JS, Shindo N, Bermingham A, Chappell JD, Van Kerkhove MD, Fowler RA. Middle East Respiratory Syndrome. N Engl J Med. 2017 Feb 9;376(6):584-594. doi: 10.1056/NEJMsr1408795.
- Yu IT, Li Y, Wong TW, Tam W, Chan AT, Lee JH, Leung DY, Ho T. Evidence of airborne transmission of the severe acute respiratory syndrome virus. N Engl J Med. 2004 Apr 22;350(17):1731-9. doi: 10.1056/NEJMoa032867.
- Kutter JS, Spronken MI, Fraaij PL, Fouchier RA, Herfst S. Transmission routes of respiratory viruses among humans. Curr Opin Virol. 2018 Feb;28:142-151. doi: 10.1016/j.coviro.2018.01.001. Epub 2018 Jan 17.
- Levy MM, Baylor MS, Bernard GR, Fowler R, Franks TJ, Hayden FG, Helfand R, Lapinsky SE, Martin TR, Niederman MS, Rubenfeld GD, Slutsky AS, Stewart TE, Styrt BA, Thompson BT, Harabin AL; National Heart, Lung, and Blood Institute; Centers for Disease Control and Prevention; Institute of Allergy and Infectious Diseases. Clinical issues and research in respiratory failure from severe acute respiratory syndrome. Am J Respir Crit Care Med. 2005 Mar 1;171(5):518-26. doi: 10.1164/rccm.200405-621WS. Epub 2004 Dec 10.
- Booth CM, Matukas LM, Tomlinson GA, Rachlis AR, Rose DB, Dwosh HA, Walmsley SL, Mazzulli T, Avendano M, Derkach P, Ephtimios IE, Kitai I, Mederski BD, Shadowitz SB, Gold WL, Hawryluck LA, Rea E, Chenkin JS, Cescon DW, Poutanen SM, Detsky AS. Clinical features and short-term outcomes of 144 patients with SARS in the greater Toronto area. JAMA. 2003 Jun 4;289(21):2801-9. doi: 10.1001/jama.289.21.JOC30885. Epub 2003 May 6. Erratum In: JAMA. 2003 Jul 16;290(3):334.
- Fowler RA, Lapinsky SE, Hallett D, Detsky AS, Sibbald WJ, Slutsky AS, Stewart TE; Toronto SARS Critical Care Group. Critically ill patients with severe acute respiratory syndrome. JAMA. 2003 Jul 16;290(3):367-73. doi: 10.1001/jama.290.3.367.
- Lew TW, Kwek TK, Tai D, Earnest A, Loo S, Singh K, Kwan KM, Chan Y, Yim CF, Bek SL, Kor AC, Yap WS, Chelliah YR, Lai YC, Goh SK. Acute respiratory distress syndrome in critically ill patients with severe acute respiratory syndrome. JAMA. 2003 Jul 16;290(3):374-80. doi: 10.1001/jama.290.3.374.
- Khalid I, Khalid TJ, Qabajah MR, Barnard AG, Qushmaq IA. Healthcare Workers Emotions, Perceived Stressors and Coping Strategies During a MERS-CoV Outbreak. Clin Med Res. 2016 Mar;14(1):7-14. doi: 10.3121/cmr.2016.1303. Epub 2016 Feb 4.
- Sandoval C, Barrera A, Ferres M, Cerda J, Retamal J, Garcia-Sastre A, Medina RA, Hirsch T. Infection in Health Personnel with High and Low Levels of Exposure in a Hospital Setting during the H1N1 2009 Influenza A Pandemic. PLoS One. 2016 Jan 22;11(1):e0147271. doi: 10.1371/journal.pone.0147271. eCollection 2016.
- Lellouche F, L'Her E. Hyperoxemia: The Poison Is in the Dose. Am J Respir Crit Care Med. 2020 Feb 15;201(4):498. doi: 10.1164/rccm.201910-1898LE. No abstract available.
- O'Driscoll BR, Howard LS, Earis J, Mak V; British Thoracic Society Emergency Oxygen Guideline Group; BTS Emergency Oxygen Guideline Development Group. BTS guideline for oxygen use in adults in healthcare and emergency settings. Thorax. 2017 Jun;72(Suppl 1):ii1-ii90. doi: 10.1136/thoraxjnl-2016-209729. No abstract available.
- Beasley R, Chien J, Douglas J, Eastlake L, Farah C, King G, Moore R, Pilcher J, Richards M, Smith S, Walters H. Thoracic Society of Australia and New Zealand oxygen guidelines for acute oxygen use in adults: 'Swimming between the flags'. Respirology. 2015 Nov;20(8):1182-91. doi: 10.1111/resp.12620.
- Burki TK. Coronavirus in China. Lancet Respir Med. 2020 Mar;8(3):238. doi: 10.1016/S2213-2600(20)30056-4. Epub 2020 Feb 3. No abstract available.
- McEvoy JW. Excess oxygen in acute illness: adding fuel to the fire. Lancet. 2018 Apr 28;391(10131):1640-1642. doi: 10.1016/S0140-6736(18)30546-4. Epub 2018 Apr 26. No abstract available.
- Rodriguez-Gonzalez R, Martin-Barrasa JL, Ramos-Nuez A, Canas-Pedrosa AM, Martinez-Saavedra MT, Garcia-Bello MA, Lopez-Aguilar J, Baluja A, Alvarez J, Slutsky AS, Villar J. Multiple system organ response induced by hyperoxia in a clinically relevant animal model of sepsis. Shock. 2014 Aug;42(2):148-53. doi: 10.1097/SHK.0000000000000189.
- Farquhar H, Weatherall M, Wijesinghe M, Perrin K, Ranchord A, Simmonds M, Beasley R. Systematic review of studies of the effect of hyperoxia on coronary blood flow. Am Heart J. 2009 Sep;158(3):371-7. doi: 10.1016/j.ahj.2009.05.037. Epub 2009 Jul 15.
- McNulty PH, King N, Scott S, Hartman G, McCann J, Kozak M, Chambers CE, Demers LM, Sinoway LI. Effects of supplemental oxygen administration on coronary blood flow in patients undergoing cardiac catheterization. Am J Physiol Heart Circ Physiol. 2005 Mar;288(3):H1057-62. doi: 10.1152/ajpheart.00625.2004.
- Musher DM, Rueda AM, Kaka AS, Mapara SM. The association between pneumococcal pneumonia and acute cardiac events. Clin Infect Dis. 2007 Jul 15;45(2):158-65. doi: 10.1086/518849. Epub 2007 Jun 6.
- Santos-Gallego CG, Badimon JJ. Cardiac Complications After Community-Acquired Pneumonia. Am J Cardiol. 2016 Jan 15;117(2):310. doi: 10.1016/j.amjcard.2015.10.003. Epub 2015 Oct 23. No abstract available.
- Brown AO, Millett ER, Quint JK, Orihuela CJ. Cardiotoxicity during invasive pneumococcal disease. Am J Respir Crit Care Med. 2015 Apr 1;191(7):739-45. doi: 10.1164/rccm.201411-1951PP.
- Sjoberg F, Singer M. The medical use of oxygen: a time for critical reappraisal. J Intern Med. 2013 Dec;274(6):505-28. doi: 10.1111/joim.12139.
- Hraiech S, Alingrin J, Dizier S, Brunet J, Forel JM, La Scola B, Roch A, Papazian L, Pauly V. Time to intubation is associated with outcome in patients with community-acquired pneumonia. PLoS One. 2013 Sep 19;8(9):e74937. doi: 10.1371/journal.pone.0074937. eCollection 2013.
- Andersen LW, Holmberg MJ, Berg KM, Donnino MW, Granfeldt A. In-Hospital Cardiac Arrest: A Review. JAMA. 2019 Mar 26;321(12):1200-1210. doi: 10.1001/jama.2019.1696.
- Carr GE, Yuen TC, McConville JF, Kress JP, VandenHoek TL, Hall JB, Edelson DP; American Heart Association's Get With the Guidelines-Resuscitation (National Registry of CPR) Investigators. Early cardiac arrest in patients hospitalized with pneumonia: a report from the American Heart Association's Get With The Guidelines-Resuscitation Program. Chest. 2012 Jun;141(6):1528-1536. doi: 10.1378/chest.11-1547. Epub 2011 Dec 22.
- Smith ME, Chiovaro JC, O'Neil M, Kansagara D, Quinones AR, Freeman M, Motu'apuaka ML, Slatore CG. Early warning system scores for clinical deterioration in hospitalized patients: a systematic review. Ann Am Thorac Soc. 2014 Nov;11(9):1454-65. doi: 10.1513/AnnalsATS.201403-102OC.
- Maharaj R, Raffaele I, Wendon J. Rapid response systems: a systematic review and meta-analysis. Crit Care. 2015 Jun 12;19(1):254. doi: 10.1186/s13054-015-0973-y.
- Liao X, Wang B, Kang Y. Novel coronavirus infection during the 2019-2020 epidemic: preparing intensive care units-the experience in Sichuan Province, China. Intensive Care Med. 2020 Feb;46(2):357-360. doi: 10.1007/s00134-020-05954-2. Epub 2020 Feb 5. No abstract available.
- Viglino D, L'her E, Maltais F, Maignan M, Lellouche F. Evaluation of a new respiratory monitoring tool "Early Warning ScoreO2" for patients admitted at the emergency department with dyspnea. Resuscitation. 2020 Mar 1;148:59-65. doi: 10.1016/j.resuscitation.2020.01.004. Epub 2020 Jan 13.
- Mahase E. Coronavirus: global stocks of protective gear are depleted, with demand at "100 times" normal level, WHO warns. BMJ. 2020 Feb 10;368:m543. doi: 10.1136/bmj.m543. No abstract available.
- Kang L, Li Y, Hu S, Chen M, Yang C, Yang BX, Wang Y, Hu J, Lai J, Ma X, Chen J, Guan L, Wang G, Ma H, Liu Z. The mental health of medical workers in Wuhan, China dealing with the 2019 novel coronavirus. Lancet Psychiatry. 2020 Mar;7(3):e14. doi: 10.1016/S2215-0366(20)30047-X. Epub 2020 Feb 5. No abstract available.
- Lellouche F, L'her E. Automated oxygen flow titration to maintain constant oxygenation. Respir Care. 2012 Aug;57(8):1254-62. doi: 10.4187/respcare.01343. Epub 2012 Feb 17.
- L'her E, Jaber S, Verzilli D, Jacob C, Huiban B, Futier E, Kerforne T, Pateau V, Bouchard PA, Gouillou M, Nowak E, Lellouche F. Automated oxygen administration versus conventional oxygen therapy after major abdominal or thoracic surgery: study protocol for an international multicentre randomised controlled study. BMJ Open. 2019 Jan 17;9(1):e023833. doi: 10.1136/bmjopen-2018-023833.
- L'Her E, N'Guyen QT, Pateau V, Bodenes L, Lellouche F. Photoplethysmographic determination of the respiratory rate in acutely ill patients: validation of a new algorithm and implementation into a biomedical device. Ann Intensive Care. 2019 Jan 21;9(1):11. doi: 10.1186/s13613-019-0485-z.
- Bourassa S, Bouchard PA, Dauphin M, Lellouche F. Oxygen Conservation Methods With Automated Titration. Respir Care. 2020 Oct;65(10):1433-1442. doi: 10.4187/respcare.07240. Epub 2020 Feb 18.
- Wang L, Fan C. Sample size calculations for comparing two groups of count data. J Biopharm Stat. 2019;29(1):115-127. doi: 10.1080/10543406.2018.1489409. Epub 2018 Jul 19.
- Vierron E, Giraudeau B. Design effect in multicenter studies: gain or loss of power? BMC Med Res Methodol. 2009 Jun 18;9:39. doi: 10.1186/1471-2288-9-39.
- Ramsey S, Willke R, Briggs A, Brown R, Buxton M, Chawla A, Cook J, Glick H, Liljas B, Petitti D, Reed S. Good research practices for cost-effectiveness analysis alongside clinical trials: the ISPOR RCT-CEA Task Force report. Value Health. 2005 Sep-Oct;8(5):521-33. doi: 10.1111/j.1524-4733.2005.00045.x.
- Claxton K. The irrelevance of inference: a decision-making approach to the stochastic evaluation of health care technologies. J Health Econ. 1999 Jun;18(3):341-64. doi: 10.1016/s0167-6296(98)00039-3.
- Denault MH, Peloquin F, Lajoie AC, Lacasse Y. Automatic versus Manual Oxygen Titration in Patients Requiring Supplemental Oxygen in the Hospital: A Systematic Review and Meta-Analysis. Respiration. 2019;98(2):178-188. doi: 10.1159/000499119. Epub 2019 May 24.
- Poder TG, Kouakou CRC, Bouchard PA, Tremblay V, Blais S, Maltais F, Lellouche F. Cost-effectiveness of FreeO2 in patients with chronic obstructive pulmonary disease hospitalised for acute exacerbations: analysis of a pilot study in Quebec. BMJ Open. 2018 Jan 23;8(1):e018835. doi: 10.1136/bmjopen-2017-018835.
- Vivodtzev I, L'Her E, Vottero G, Yankoff C, Tamisier R, Maltais F, Lellouche F, Pepin JL. Automated O2 titration improves exercise capacity in patients with hypercapnic chronic obstructive pulmonary disease: a randomised controlled cross-over trial. Thorax. 2019 Mar;74(3):298-301. doi: 10.1136/thoraxjnl-2018-211967. Epub 2018 Aug 30.
- Mahase E. China coronavirus: what do we know so far? BMJ. 2020 Jan 24;368:m308. doi: 10.1136/bmj.m308. No abstract available.
- Lewis D. Coronavirus outbreak: what's next? Nature. 2020 Feb;578(7793):15-16. doi: 10.1038/d41586-020-00236-9. No abstract available.
- Arabi YM, Fowler R, Hayden FG. Critical care management of adults with community-acquired severe respiratory viral infection. Intensive Care Med. 2020 Feb;46(2):315-328. doi: 10.1007/s00134-020-05943-5. Epub 2020 Feb 10.
- Bogoch II, Watts A, Thomas-Bachli A, Huber C, Kraemer MUG, Khan K. Potential for global spread of a novel coronavirus from China. J Travel Med. 2020 Mar 13;27(2):taaa011. doi: 10.1093/jtm/taaa011.
- As coronavirus spreads, the time to think about the next epidemic is now. Nature. 2020 Feb;578(7794):191. doi: 10.1038/d41586-020-00379-9. No abstract available.
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (预期的)
研究完成 (预期的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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