重症のCOVID-19患者の吸入セボフルーラン:遡及的なコホート研究
Jose J Zaragoza1, Marco A Baez-Garcia2,3, Jose M Lomeli-Teran2,4
1Hospital H+ Queretaro, Santiago de Querétaro,Mexico.
まとめ
重症のCOVID-19患者の補助的な吸入セボフルーランは鎮静剤の投与量を低下させなかったが,機械的換気を長引かせ,抗精神病薬の必要性を増加させた. 離乳と妄想の管理には注意が必要です.
科学分野:
- クリティカルケア・メディシン
- アネステシオロジー アネステシオロジー
- 感染症 感染症は感染症です.
背景:
- 重症のCOVID-19患者の鎮静管理は,高い鎮静剤の必要性と,臓器機能不全による薬物の代謝の変化による課題を提示します.
- 吸入セボフルーランは,肺から排出される鎮静剤の代替品であり,薬物の蓄積を潜在的に減らす可能性があります.
研究 の 目的:
- 機械呼吸器によるCOVID-19患者の補助的な鎮静策として,吸入セボフルーランの有効性を評価する.
- セボフルーランを投与された患者と,静脈内静止剤のみを投与された患者との間で,累積的な静脈内静止剤の負担,機械呼吸器の持続時間,および抗精神病薬の使用を比較するために.
主な方法:
- 単一センターの遡及的なコホート研究では,機械呼吸器を施したCOVID-19患者43人が参加しました.
- 患者は2つのグループに分けられました:静脈内 (IV) 鎮静剤 (n=30) とIV鎮静剤単独 (n=13) に添加された吸入セボフルーラン.
- プライマリアウトカムは,7日間の累積IV鎮静剤投与であり,二次的なアウトカムには,エクスチューベーションまでの時間および抗精神病薬の使用が含まれていました.
主要な成果:
- セボフルーランと対照群の間で,累積IV鎮静剤の投与量において有意な差は認められなかった.
- セボフルーラン群は,機械呼吸器の平均期間 (206時間対144時間) と抗精神病薬の使用量 (66.6%対15.3%) を大幅に延長した.
- セボフルーラン群では,特定の日にプロポポールの日用量が低かったが,全体的な鎮静剤の負担は変わらなかった.
結論:
- 補助的な吸入セボフルーランは,このCOVID-19コホートにおける累積的なIV鎮静剤の負荷を有意に軽減しませんでした.
- セボフルーランの使用は,エクストゥベーションの遅延と抗精神病薬の必要性の増加と関連していました.
- 結果は,COVID-19患者の鎮静剤としてセボフルーランを使用する際には,特に呼吸器離乳と妄想管理に関する注意を払うことを示唆しています.
キーワード:
COVID-19は,コロナウイルスによるデリリウム・デリリウム集中治療室の重症病棟で集中治療を受けています.機械換気による換気です.鎮静剤 鎮静剤 鎮静剤セボフルーランはセボフルーランです.さらに関連する動画
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