在患有SARS-CoV-2的患者中,非侵入性呼吸支持的失败
Juan Javier García-Fernández1, José Andrés Sánchez-Nicolás2, Sonia Galicia-Puyol3
1Health Sciences PhD Program, Catholic University of Murcia UCAM, Campus de los Jerónimos nº135, Guadalupe, 30107 Murcia, Spain.
Journal of clinical medicine
|October 28, 2023
概括
对于COVID-19患者的低血症急性呼吸衰竭,高流量鼻氧 (HFNO) 和CPAP治疗的联合治疗显示出比Bilevel更低的失败率. 这种非侵入性呼吸辅助在住院期间是安全有效的.
科学领域:
- 肺部病理学 肺部病理学
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
背景情况:
- 在SARS-CoV-2患者中,低血症急性呼吸衰竭 (ARF) 需要有效的非侵入性呼吸支持 (NIRS).
- 评估各种NIRS疗法的失败率对于优化患者的治疗结果至关重要.
研究的目的:
- 评估高流量鼻氧 (HFNO),CPAP,Bilevel和联合疗法的有效性,用于治疗由于SARS-CoV-2引起的缺血性ARF.
- 确定在住院COVID-19患者中失败率最低的NIRS策略.
主要方法:
- 对197名SARS-CoV-2阳性患者进行了回顾性观察性研究,需要NIRS.
- 评估的疗法包括HFNO,CPAP,Bilevel及其组合.
- 数据是在2020年3月至2021年5月期间在雷纳索菲亚总大学医院收集的.
主要成果:
- 在197名纳入患者中,NIRS总体失败率为48.3%.
- 与Bilevel治疗相比,联合HFNO和CPAP治疗的失败率较低 (p=0.005).
- 没有两种水平的气道压力 (HFNO,CPAP,联合HFNO/CPAP) 的疗法失败率为24.2%,比Bilevel疗法失败率为75.8% (p=0.001).
结论:
- 非侵入性呼吸辅助 (NIRS) 对于与SARS-CoV-2相关的呼吸衰竭是安全有效的.
- 胆汁治疗与治疗失败的可能性增加有关.
- 结合CPAP和HFNO疗法成为一个有前途的策略,用于管理COVID-19患者的低血量ARF.
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