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Updated: Jun 30, 2025

A Model to Simulate Clinically Relevant Hypoxia in Humans
Published on: December 22, 2016
低対高酸素目標とCOVID-19における生命維持装置なしの生存日:HOT-COVIDランダム化臨床試験
Frederik M Nielsen1,2, Thomas L Klitgaard1, Martin Siegemund3
1Department of Anaesthesia and Intensive Care, Aalborg University Hospital, Aalborg, Denmark.
集中治療室での重度の低酸素症のCOVID-19患者の酸素濃度を下げることで,結果が改善されました. 90mmHgと比較して60mmHgのPao2をターゲットにすると,生命維持装置なしで生き延びる日数が増加しました.
科学分野:
- クリティカル ケア 医療
- 肺科
- 感染症
背景:
- 酸素補給は,重度の低酸素症のCOVID-19患者にとって標準的です.
- しかし,より低量の酸素は臨床的な利点を提供することがあります.
研究 の 目的:
- 低パオ2 (60mmHg) と高パオ2 (90mmHg) を標的とする効果を,COVID-19および重度の低酸素症の重症治療室 (ICU) の患者で比較する.
主な方法:
- 多中心のランダム化臨床試験では,欧州ICUの成人COVID-19患者726人が参加した.
- 患者は最大90日間60mmHg (n=365) または90mmHg (n=361) のPao2をターゲットにランダムに割り当てられました.
- 生命維持装置なしでの生存期間は90日でした.
主要な成果:
- 酸素濃度が低いグループ (Pao2 60 mm Hg) は,生命維持装置なしで平均80. 0日生き,酸素濃度が高いグループ (Pao2 90 mm Hg) は72. 0日 (P=. 009) でした.
- 90日後の死亡率は,低酸素化群では30. 2%,高酸素化群では34. 7%であった (P=. 18).
- 重篤な有害事象や病院の外での生存日数において,有意な差異は認められなかった.
結論:
- COVID-19と重度の低酸素症のICU患者で60mmHgのPao2をターゲットにすると,90mmHgのターゲットと比較して,生命維持装置なしで生存する日数が増加しました.
- これは,この患者集団において,保守的な酸素療法による潜在的な利益を示唆している.
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