慢性肺炎恶化:为什么避免ICU入院很重要
Irene Prediletto1,2, Gilda Giancotti1, Stefano Nava1,2
1Alma Mater Studiorum University of Bologna, Department of Medical and Surgical Science (DIMEC), Via Massarenti 9, 40138 Bologna, Italy.
Journal of clinical medicine
|May 27, 2023
概括
慢性阻塞性肺病 (AECOPD) 的急性恶化严重影响患者的治疗结果和医疗保健资源. 改善AECOPD知识和管理,包括非侵入性通风,对于减少住院和死亡率至关重要.
科学领域:
- 肺部病理学 肺部病理学
- 关键护理医学 关键护理医学
- 流行病学 流行病学
背景情况:
- 慢性阻塞性肺病 (COPD) 是全球主要的疾病和死亡原因.
- 慢性慢性肺炎的急性恶化 (AECOPD) 代表着严重的医疗负担,影响患者的预后和资源利用.
- 导致急性呼吸衰竭 (ARF) 的严重AECOPD经常需要进入重症监护室 (ICU) 和侵入性机械通风.
研究的目的:
- 审查关于AECOPD的流行,结果和管理的当前证据,特别是在重症患者中.
- 突出在行政数据中准确诊断COPD和AECOPD的挑战.
- 强调非侵入性通风在预防AECOPD和减少ICU入院的潜在作用.
主要方法:
- 关于AECOPD,ICU入院和通风策略的综合文献综述.
- 对AECOPD报告的ICU入院率,住院死亡率和再住院率的分析.
- 检查非侵入性通风对AECOPD结果的影响.
主要成果:
- 对于AECOPD的ICU入院率在2-19%之间,在医院内死亡率为20-40%,再住院率为18%.
- 在行政数据中低估了COPD诊断,导致ICU中AECOPD的流行率不准确.
- 非侵入性通风可以预防AECOPD,减少ICU入院,并降低死亡率,特别是在超性ARF.
结论:
- AECOPD仍然是一个关键的临床挑战,患病率和死亡率显著.
- 准确的诊断和有效的管理策略,包括非侵入性通风,对于改善患者的治疗结果至关重要.
- 需要进一步的研究和改进的临床实践来解决AECOPD知识和管理中的持续问题.
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