由于未能将严重的COVID-19ARDS分类为通过临床 - 基因病理关系研究的呼吸器亚型
Riccardo Colombo1, Maddalena Alessandra Wu2, Davide Ottolina1
1Division of Anesthesiology and Intensive Care, ASST Fatebenefratelli Sacco, Milan, Italy.
Respiratory medicine
|June 1, 2023
概括
在严重的COVID-19ARDS中,呼吸道顺应的恶化与肺组织损伤的进展有关. 这凸显了需要考虑机弹性特性与组织病理学一起,以更好地确定患者的亚型.
科学领域:
- 关键护理医学 关键护理医学
- 肺部病理学 肺部病理学
- 病理学 病理学 病理学
背景情况:
- 严重的COVID-19相关的急性呼吸系统应急综合征 (CARDS) 亚型缺乏对呼吸机械弹性特征和组织病理模式的考虑.
- 了解这些轨迹对于准确的患者分层至关重要.
研究的目的:
- 评估机弹性呼吸系统特征与肺部病原学发现之间的相关性.
- 在死于CARDS的重症患者中调查这些相关性.
主要方法:
- 分析了来自机械呼吸患者的每日呼吸数据,这些患者患有严重的CARDS.
- 通过对已故患者进行全面尸检进行组织病理学评估.
- 分类为"低"和"高"呼吸系统合规组.
主要成果:
- 在呼吸系统的符合性和晚期扩散性扩散性膜损伤 (DAD) 之间发现了反向相关性.
- 低遵守与更广泛的晚期增殖性DAD和更长的ICU停留时间有关.
- 集群分析支持了这些临床 - 基因病理相关性.
结论:
- 在CARDS患者中,呼吸系统符合性恶化与病理过渡到晚期纤维增殖模式相关.
- 目前将CARDS分为呼吸器亚表型的分类可能无法完全捕捉其病理学复杂性.
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