每日ROX指数可以预测HFNC的COVID-19患者在未来24小时内过渡到机械通风
Victor Côrtes Pourchet de Carvalho1, Bruno Leonardo da Silva Guimarães2, Mellina Tamy Fagundes Fujihara2
1Department of Medicine, Medical School, Universidade Federal Fluminense, Niteroi, Rio de Janeiro, Brazil.
The American journal of emergency medicine
|September 9, 2023
概括
在高流量鼻管 (HFNC) 上的COVID-19患者中,每日ROX指数测量有效预测24小时内需要机械通风 (MV). 这种工具有助于管理低氧化症并防止侵入性支持.
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:
- 高流量鼻腔管 (HFNC) 是COVID-19相关低氧症的关键治疗方法.
- 呼吸速率-氧化率 (ROX) 指数预测了重症监护室 (ICU) 住院早期的HFNC故障.
- 然而,在ICU入院的最初几天,患者的病情可能会发生显著的变化.
研究的目的:
- 评估ROX指数对侵袭性呼吸辅助需求的预测能力.
- 评估在ICU入院前四天内的ROX指数测量是否预测在随后的24小时内需要机械通风 (MV).
主要方法:
- 在ICU中的成年COVID-19肺炎患者的回顾性横截面研究.
- 每天计算HFNC患者的ROX指数.
- 接收器操作特性 (ROC) 曲线分析以确定预测准确性.
主要成果:
- 包括249名患者;48%需要MV.
- 聚合的4天ROX指数显示了向MV过渡的强有力的预测值 (ROC下的面积=0.86).
- 4.06的ROX指数切线预测了24小时内对MV的需求,准确度很高.
结论:
- 每日ROX指数测量有效预测使用HFNC的COVID-19患者过渡到机械通风.
- 这种预测能力可以延长到ICU停留的四天.
- 罗克斯指数是临床决策的宝贵工具,用于对低血量COVID-19患者的呼吸支持进行临床决策.
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