带有和没有COVID-19的气管切除患者的特征和结果
Jeeyune Bahk1, Bridget Dolan2, Venus Sharma1
1Department of Medicine, Mount Sinai Morningside and Mount Sinai West, Icahn School of Medicine at Mount Sinai, New York, NY.
Critical care explorations
|August 7, 2023
概括
接受气管切除术的COVID-19阳性患者最初的呼吸系统支持需求更高,但死亡率明显降低. 长时间的断奶不应该阻止这些患者进行气管切除术.
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的气管切除患者的结果还没有得到很好的确立.
- 现有的文献提出了关于COVID-19对气管切除术患者的影响的相互矛盾的证据.
研究的目的:
- 为了评估COVID-19对气管切除术患者的影响.
- 为了比较COVID-19阳性和阴性队列之间的临床结果和断奶参数.
主要方法:
- 在纽约市重症监护室 (ICU) 接受气管切除术的604名患者的回顾性观察队列研究 (2020年3月 - 2021年9月).
- 患者被分为COVID-19阳性 (COVID+ve) 和阴性 (COVID-ve) 组.
- 对临床特征,结果和断奶参数的分析,包括压力支 (PS),气管切除项圈 (TC),语音和断管.
主要成果:
- COVID+ve患者的并发症较少,但需要更高的Fio2和PEEP在气管切除术.
- 气管切开术后并发症发生率没有差异.
- COVID+ve患者的初始断奶时间 (PS,TC) 较长,但与语音安置和脱管的时间相似.
- 在COVID+ve组中,1年死亡率显著降低 (23.3%与36.7%相比),长期急性护理医院 (LTACH) 的出院率更高 (23.8%与13.6%相比).
结论:
- 虽然COVID-19患者在气管切除术时需要更高的呼吸系统支持,但并发症率相似.
- 尽管最初的断奶时间较长,但COVID-19阳性患者表现出良好的结果,包括较低的死亡率.
- 更高的呼吸系统支持和长时间的断奶不应该阻止COVID-19患者的气管切除术.
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