机械通风COVID-19患者的倾斜定位:启动时间和结果
Alexander Jackson1, Florence Neyroud2, Josephine Barnsley2
1NIHR Biomedical Research Centre, University Hospital Southampton and University of Southampton, Southampton SO16 6YD, UK.
Journal of clinical medicine
|July 14, 2023
概括
倾斜的位置改善了机械通风COVID-19患者的氧化,无论时间如何. 倾斜定位的早期,中期和晚期启动都显示出有利的氧化反应.
科学领域:
- 关键护理医学 关键护理医学
- 呼吸系统生理学 呼吸系统生理学
- 传染性疾病 传染性疾病
背景情况:
- 由于COVID-19大流行,需要广泛使用倾斜定位来改善重症患者的氧化.
- 关于倾斜定位启动时间如何影响机械通风COVID-19患者的结果的数据有限.
研究的目的:
- 分析在不同时间点启动倾斜定位对机械通风COVID-19患者的氧化的影响.
- 评估早期,中期和晚期易感定位策略的有效性.
主要方法:
- 在144名机械通风COVID-19患者中对931次易受定位事件的回顾性分析.
- 从静脉注射开始,化周期分为早期 (7天内),中期 (7-14天) 和晚期 (>14天) 的分类.
- 测量PaO2/FiO2比率 (ΔPF) 的变化,作为氧化反应的指标.
主要成果:
- 在所有proning事件中 (p < 0.001) 观察到氧化水平显著改善 (平均 ΔPF 为 16.6 mmHg).
- 在早期 (18.5 mmHg),中期 (13.2 mmHg) 和晚期 (14.8 mmHg) 倾向定位周期 (p = 0.2) 之间没有发现氧化反应的显著差异.
- 即使在输管术后14天以上开始倾斜定位时,也注意到了有利的氧化反应.
结论:
- 在所有启动时间点上,倾斜的位置对机械通风COVID-19患者的氧化有有益影响.
- 倾斜定位启动的时间不会显著改变氧化反应.
- 需要进一步的研究来确定这些发现是否转化为更好的生存优势.
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