倾向性与后背位置通风在输管COVID-19患者:一个系统性审查和元分析
Mohamed Fayed1, Wissam Maroun1, Ahmed Elnahla1
1Anesthesiology, Pain Management and Perioperative Medicine, Henry Ford Health System, Detroit, USA.
Cureus
|June 30, 2023
概括
在COVID-19肺炎的机械通风期间,倾斜的定位与卧的定位相比,没有显示死亡率的好处. 事实上,容易的定位与高的ICU死亡率和COVID-19患者的更长的住院时间有关.
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:
- 对于COVID-19肺炎机械通风患者的最佳定位策略仍然不确定.
- 俯卧是一种用于改善急性呼吸困扰综合征 (ARDS) 氧化率的技术.
- 对于COVID-19肺炎而言,倾向性与卧姿定位的具体好处需要进行系统的评估.
研究的目的:
- 在机械通风的COVID-19肺炎患者中,系统地审查和分析比较倾向与仰卧位置的研究.
- 确定定位对死亡率 (医院,整体,ICU) 和其他临床结果的影响.
主要方法:
- 对前性和后性队列研究进行系统审查和元分析.
- 在2023年4月之前搜索过数据库 (Ovid Medline,Embase,Web of Science)
- 分析了七项研究 (5216名患者),比较了COVID-19的倾向性和仰卧式通风的结果.
主要成果:
- 在易受感染的组中,重症监护室 (ICU) 死亡率明显高于易受感染的组 (OR 2.22,p=0.0004).
- 在倾斜和卧卧组之间在医院或整体死亡率上没有发现显著差异.
- 易患组的住院时间明显长 (MD 6.06天,p<0.0001);ICU住院时间和机械通风日没有差异.
结论:
- 对于COVID-19肺炎的机械通风时,倾斜的位置可能不会比卧卧的位置提供死亡率的好处.
- 观察到的ICU死亡率的增加和长时间住院的情况,需要仔细考虑.
- 可能需要进一步的研究来确定可能受益于倾斜定位的患者子组.
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