预测COVID-19相关呼吸衰竭患者不良结果的预测因素:一项回顾性观察性研究
Akhlesh Rajpoot1, Mayank Mishra2, Saikat Banerjee3
1Senior Resident.
The Journal of the Association of Physicians of India
|June 25, 2023
概括
在严重的COVID-19中预测不良结果至关重要. 晚年,并发病,以及像D-二次体和IL-6这样的炎症标志物升高与这些患者的死亡率增加有关.
科学领域:
- 临界护理医学 临界护理医学
- 传染性疾病 传染性疾病
- 肺部病理学 肺部病理学
背景情况:
- 冠状病毒疾病2019 (COVID-19) 可能导致严重的呼吸衰竭,需要进入重症监护室 (ICU).
- 识别严重的COVID-19中不良结果的预测因素对于患者管理至关重要.
研究的目的:
- 确定预测中度至重度COVID-19患者进入ICU的不良结果的因素.
- 评估临床评分在预测死亡率方面的有用性.
主要方法:
- 对120名在ICU中的COVID-19患者的医院记录进行了回顾性分析.
- 收集人口统计,临床和实验室数据.
- 将数据与结果参数进行比较,包括存活率和不良事件.
主要成果:
- 男人占主导地位 (70%),平均年龄为54.44岁.
- 常见的症状包括呼吸困难,咳和发烧;糖尿病和高血压等并发症很普遍.
- 血清D-二聚合物,费里丁,IN-6 (IL-6) 的水平增加,以及未接种疫苗的状态与较高的死亡率相关.
- 世界卫生组织 (WHO) 临床进展量表和国家早期预警分数2 (NEWS 2) 显示出死亡率预测的高特异性.
结论:
- 高龄和并发症是严重的COVID-19中不良结果的重要风险因素.
- 持续升高的D-二次体水平可能表明死亡风险增加.
- 世卫组织临床进展量表和NEWS 2是预测重症COVID-19患者死亡率的宝贵工具.
相关概念视频
Acute Respiratory Failure-V
169
The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...
Ensure that patients are monitored continuously for their response to therapy, including changes in...
169
Acute Respiratory Failure-III
232
Hypercapnic respiratory failure, also known as Type 2 or ventilatory respiratory failure, is a severe condition characterized by the body's inability to effectively remove carbon dioxide (CO2) from the bloodstream. It leads to an arterial CO2 pressure (PaCO2) exceeding 45 mmHg and a blood pH above 7.35. This situation indicates that the body's ventilatory demand, or the ventilation needed to maintain normal PaCO2 levels, surpasses its supply or the maximum gas flow achievable without...
232
Acute Respiratory Failure-I
253
Acute respiratory failure is a condition characterized by the inability of the lungs to perform their primary function: gas exchange. This failure leads to insufficient oxygen levels (hypoxemia) in the blood, elevated carbon dioxide levels (hypercapnia), or both, causing critical impairment in organ function.
Definition: It is defined by specific criteria based on blood gas measurements. Hypoxemia happens when the partial pressure of oxygen (PaO2) falls below 60 mmHg. At the same time,...
Definition: It is defined by specific criteria based on blood gas measurements. Hypoxemia happens when the partial pressure of oxygen (PaO2) falls below 60 mmHg. At the same time,...
253
Acute Respiratory Failure-IV
179
Respiratory failure can manifest suddenly or gradually, characterized by a rapid decline in PaO2 and a rapid rise in PaCO2. This situation indicates a severe respiratory problem that may quickly become a life-threatening emergency. One of the early signs of hypoxemic Acute Respiratory Failure (ARF) is a change in mental status due to the brain's sensitivity to oxygen levels and changes in acid-base balance. Symptoms such as restlessness, confusion, and agitation suggest inadequate oxygen...
179
Acute Respiratory Failure-II
285
Type I Respiratory Failure, or hypoxemic respiratory failure, occurs when the partial pressure of oxygen (PaO2) in arterial blood falls below 60 mmHg while breathing room air without a corresponding increase in arterial carbon dioxide levels (PaCO2). This condition highlights a significant impairment in the lungs' capacity to oxygenate the blood.
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
285
Pneumonia III: Complications and Assessment
278
Pneumonia poses the potential for numerous complications that warrant consideration. These complications include the following:
278


