COVID-19患者における皮膚経口術:遡及的なコホート研究
Sofia Wagemaker Viana1, Brenda Feres1, Gabriel Roberto2
1Physician. Kursk State Medical University (KSMU), Kursk, Russia.
Sao Paulo medical journal = Revista paulista de medicina
|September 3, 2025
まとめ
COVID-19患者の早期の皮膚経口管内術 (PT) は生存率を向上させ,集中治療室 (ICU) の滞在を短縮する可能性があります. この研究では,重症で機械呼吸器 (MV) を必要とする患者のPTのタイミングとアウトカムを評価した.
科学分野:
- クリティカル ケア 医療
- 呼吸器医学
- 感染症
背景:
- COVID-19 パンデミックはヘルスケアシステムに負担をかけ,機械呼吸器 (MV) の需要が増加しました.
- パーキュタヌス・トラキオストミー (PT) は,集中治療室 (ICU) の滞在を短縮し,機械呼吸器患者のリソース利用を最適化するために研究されている.
- COVID-19患者におけるPTの最適なタイミング,安全性,結果については不確実性があります.
研究 の 目的:
- COVID-19患者における経皮気管切開 (PT) の技術的側面について説明する.
- この集団におけるPTに関連した早期の安全性および短期生存因子を評価する.
- 重症のCOVID-19患者のアウトカムに対するPTのタイミングの影響を分析する.
主な方法:
- 連続したPTを受けた103人のCOVID-19患者の遡及分析 (2020年3月~6月).
- 分析された要因には,年齢,性別,PTのタイミング,肺の関与,併発症,呼吸器のパラメータが含まれていた.
- 単変数および多変数コックス比例リスク回帰モデルは生存予測要因を特定するために使用されました.
主要な成果:
- この研究には103人の患者が含まれており,その大半は男性で,平均年齢は68歳でした.
- 併発性疾患には高血圧 (52%),糖尿病 (36%),心臓病 (21%) が含まれていた.
- 生存率は60歳以上の患者で減少した (HR=3. 35),より早いPT (<10日,HR=0. 37) と高鼻流カテーテル使用で改善した (HR=0. 49).
結論:
- 選択されたCOVID-19患者の早期PTは,機械呼吸器の持続時間とICUの滞在時間を短縮する可能性があります.
- この調査結果は,重症のCOVID-19患者の管理においてPTが貴重なツールとなることを示唆しています.
- パンデミック中の呼吸器とICUベッドの不足により,ヘルスケアシステムは大きな負担に直面しています.
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