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外体膜氧化以支持COVID-19患者:一种倾向匹配的队列研究
Björn Stessel1,2, Maayeen Bin Saad1, Lotte Ullrick1
1Department of Intensive Care and Anaesthesiology, Jessa Hospital, Hasselt, Belgium.
身体外膜氧化 (ECMO) 可能会使严重的COVID-19肺炎患者的死亡率与单独的最大侵入性机械通风 (MVA) 相比增加三倍. 这项研究没有证实先前的发现,表明ECMO的好处.
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
- 传染性疾病 传染性疾病
背景情况:
- 严重的COVID-19肺炎可能导致呼吸衰竭,需要先进的呼吸支持.
- 身体外膜氧化 (ECMO) 在传统治疗不足时提供肺保护性通风.
- 仅限于最大侵入性机械通风 (MVA) 是一种替代治疗策略.
研究的目的:
- 为了比较ECMO与MVA对严重COVID-19肺炎死亡率和并发症的影响.
- 进行确认性倾向匹配的队列研究,以验证先前的发现.
主要方法:
- 一项队列研究包括295名患有严重COVID-19肺炎的成年患者.
- 患者根据治疗计划进行分类:ECMO,MVA,或做-not-intubate.
- 倾向性得分匹配用于比较24名ECMO患者与24名MVA患者.
主要成果:
- 在ECMO组 (45.8%) 和MVA组 (16.67%),ICU死亡率显著更高.
- 与MVA (16.67%) 相比,ECMO (50%) 的三个月死亡率也更高.
- 与ECMO相比,MVA使用的峰值吸气压力和PEEP水平更高.
结论:
- 与MVA相比,ECMO治疗可能会使ICU和3个月死亡率增加三倍.
- 这项研究无法证实先前的发现,表明ECMO在严重的COVID-19中具有好处.
- 需要进一步的研究来澄清ECMO在治疗COVID-19严重呼吸衰竭中的作用.
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