不同抗凝剂量对中度至重度COVID-19肺炎与低氧症的影响
Amin Ur Rehman Nadeem1, Syed M Naqvi2, Kurian G Chandy2
1Department of Critical Care Medicine, James A Lovell Federal Healthcare Center, Chicago Medical School at Rosalind Franklin University of Medicine and Science, North Chicago, USA.
Cureus
|September 13, 2023
概括
抗凝剂剂量对住院COVID-19患者的机械通风需求或死亡率没有显著影响. 然而,在需要高流氧的患者中,升级的抗凝血更为常见,这表明在严重的低氧化症中可能有好处.
科学领域:
- 内部医学 内部医学
- 肺部病理学 肺部病理学
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
背景情况:
- COVID-19是一种与血栓栓塞,微血栓,多器官衰竭和死亡相关的原血栓状况.
- 对于COVID-19患者的抗凝血药物的既定指南缺乏关于最佳剂量策略的共识.
- 低氧症是COVID-19肺炎中疾病严重程度的关键指标.
研究的目的:
- 调查不同抗凝剂量 (预防性,升级性,治疗性) 对住院COVID-19患者肺炎和低氧化症的临床结果的影响.
- 根据抗凝策略,确定需要高流量氧气,机械通风和整体死亡率的差异.
- 确定可能从特定的抗凝血疗法中受益最多的患者子组.
主要方法:
- 对132名被诊断为COVID-19,肺炎和低氧血症 (室内空气中氧和率<94%) 的住院患者的回顾性图表审查.
- 对结果的分析,包括高流量氧气的使用,机械通风的要求和死亡率.
- 对不同抗凝剂剂量策略的结果进行比较:预防性,升级性和治疗性.
主要成果:
- 该研究包括132名患者 (87%是男性,平均年龄为59岁),糖尿病 (33%) 和高血压 (50%) 的患病率很高.
- 53%的患者需要进入重症监护室 (ICU),8%需要机械呼吸,12%的患者死亡.
- 不同的抗凝剂剂量策略之间没有观察到死亡率或机械通风需求的统计学上显著差异. 死亡的患者更容易使用各种形式的呼吸辅助.
结论:
- 不同剂量的抗凝剂没有显示出与机械通风的需要或这一队列的整体死亡率有统计学意义的关系.
- 接受升级抗凝剂剂量的患者中,与不接受高流氧的患者相比,需要高流氧的比例更高.
- 目前的抗凝策略没有显示出对住院COVID-19患者肺炎和低氧化症的整体存活率的统计学显著影响.
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