高流氧疗法与常规氧疗法对严重COVID-19患者的侵入性机械通风和临床恢复的影响:随机临床试验
Gustavo A Ospina-Tascón1,2, Luis Eduardo Calderón-Tapia1,2, Alberto F García1,2
1Department of Intensive Care, Fundación Valle del Lili, Cali, Colombia.
JAMA
|December 7, 2021
概括
与传统氧气疗法相比,高流氧疗法显著降低了机械通风的需要,并改善了严重的COVID-19患者的临床恢复时间.
科学领域:
- 危急护理医学
- 呼吸系统医学
- 传染性疾病
背景情况:
- 在严重的COVID-19中,高流氧疗法 (HFOT) 与常规氧疗法 (COT) 的疗效尚不清楚.
- 严重的COVID-19会给呼吸系统带来重大挑战,往往需要先进的氧化支持.
研究的目的:
- 通过鼻对重症COVID-19患者的HFOT疗效进行比较.
- 评估对内内输管率和临床恢复时间的影响.
主要方法:
- 一个随机的,开放的临床试验,涉及220名患有严重COVID-19和呼吸困难的成年人.
- 患者被分配为HFOT (n=109) 或COT (n=111).
- 主要结局包括需要输管治疗和28天内临床康复的时间.
主要成果:
- 与COT (51. 0%) 相比,HFOT组的输管率明显较低 (34. 3%).
- 临床康复的中位时间在HFOT (11天) 与COT (14天) 之间较短 (HR,1. 39;P=. 047).
- 两组之间疑似细菌性肺炎或细菌病率没有显著差异.
结论:
- 在严重的COVID-19患者中,HFOT通过鼻腔管优于COT.
- HFOT减少了机械通风的需求,并加速了临床康复.
- 这种疗法在治疗COVID-19中严重的呼吸困难方面具有显著的益处.
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