由于COVID-19而导致严重ARDS的倾斜位置通风:长期和间歇策略之间的比较
George Karlis1, Despina Markantonaki1, Sotirios Kakavas2
1ICU, Thoracic Diseases General Hospital "Sotiria", 115 27 Athens, Greece.
Journal of clinical medicine
|May 27, 2023
概括
在严重的COVID-19ARDS中,长时间的倾斜定位 (PPP) 是安全有效的. 然而,延长容易通风的持续时间超出标准方案并没有改善28天的生存率.
科学领域:
- 关键护理医学 关键护理医学
- 呼吸系统医学 呼吸系统医学
- 传染性疾病 传染性疾病
背景情况:
- 每天躺下12-16小时可以改善急性呼吸困扰综合征 (ARDS) 的存活率.
- 在COVID-19相关的ARDS中,PP干预的最佳持续时间仍未确定.
研究的目的:
- 在患有COVID-19相关ARDS的患者中,比较长时间倾斜定位 (PPP) 协议与常规倾斜通风 (SPP) 的疗效和安全性.
主要方法:
- 一项前性观察性研究,包括63名COVID-19 ARDS的患者.
- 根据氧化标准 (P/F < 150,FiO2 > 0.6,PEEP > 10厘米H2O),患者接受了SPP (中位数20小时) 或PPP (中位数46小时).
- 氧化参数和呼吸机制在基线,PP末期和4小时后被记录下来.
主要成果:
- 在SPP和PPP组之间,氧化,呼吸机制,PP周期数量或并发症率没有显著差异.
- 在PPP组的28天生存率为78.4%,在SPP组为65.4% (p=0.253).
结论:
- 在严重的COVID-19ARDS中延长容易定位的持续时间与传统协议一样安全和有效.
- 长时间躺卧并没有在这个队列中产生显著的生存益处.
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