在COVID-19中易受定位时的神经肌肉阻塞和氧化变化
Thomas C Rollinson1, Luke A McDonald2, Joleen Rose2
1Department of Intensive Care, Austin Health, Melbourne, VIC, Australia; Department of Physiotherapy, Austin Health, Melbourne, VIC, Australia; Department of Physiotherapy, The University of Melbourne, Melbourne, VIC, Australia; Institute for Breathing and Sleep, Melbourne, VIC, Australia.
神经肌肉阻断剂 (NMBs) 在倾斜定位期间改善了COVID-19 ARDS患者的氧化. 这种好处在返回卧姿后仍然存在,这表明NMBs有助于通风管理.
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
- 药理学 药理学是指药理学的学科.
背景情况:
- 倾斜的定位是严重的COVID-19急性呼吸困扰综合征 (ARDS) 的关键干预措施.
- 神经肌肉阻断剂 (NMBs) 经常在倾斜的位置下使用,以优化机械通风.
- 在COVID-19 ARDS中易受治疗期间,NMBs对氧化的确切影响尚不完全理解.
研究的目的:
- 研究神经肌肉阻断剂 (NMBs) 对侵袭性通风成年患者的氧化效应,这些患者患有与COVID-19相关的ARDS,并经历易感定位.
- 在倾斜定位期间和之后,在接受NMB和不接受NMB的患者之间比较氧化水平 (PaO2:FiO2比率).
主要方法:
- 一项涉及COVID-19ARDS的成年患者的多中心观察性研究,需要侵入性机械通风.
- 数据收集包括患者的人口统计,易感定位细节,NMB管理和临床结果.
- 动脉血液的气体参数在卧卧的位置,倾斜的位置以及返回卧卧的位置时被分析.
主要成果:
- 在倾斜定位时接受NMB的患者显示,与没有NMB (161 mmHg) 的患者相比,平均PaO2:FiO2比率 (208 mmHg) 显著更高.
- 与基线相比,PaO2:FiO2比率的增加在NMB组 (76 mmHg) 与非NMB组 (55 mmHg) 在倾斜定位期间更大.
- 这种氧化益处在返回卧姿后持续,在NMB组 (190 mmHg) 观察到较高的PaO2:FiO2比率,与非NMB组 (141 mmHg) 相比.
结论:
- 神经肌肉阻断剂与在COVID-19 ARDS患者接受倾斜定位时的改善氧化有关.
- 对于氧化,NMBs的积极作用即使在患者返回卧卧姿势后也会持续下去.
- 这些发现支持合理使用NMB来增强COVID-19 ARDS患者的通风和氧化策略.
更多相关视频
05:46A Novel Inhalation Mask System to Deliver High Concentrations of Nitric Oxide Gas in Spontaneously Breathing Subjects
Published on: May 4, 2021
09:36Halogenated Agent Delivery in Porcine Model of Acute Respiratory Distress Syndrome via an Intensive Care Unit Type Device
Published on: September 24, 2020
相关概念视频
Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacological Actions
Although all competitive neuromuscular blockers are designed...
Anatomical Positions
The body is upright, facing forward, and standing erect.
The feet are parallel and flat on the floor.
The arms are hanging by the...
Skeletal Muscle Relaxants: Therapeutic Uses
Depolarizing Blockers: Mechanism of Action
Succinylcholine is the most commonly used depolarizing blocker. Chemically, it constitutes two molecules of acetylcholine joined together by an acetate methyl group. They act on the receptors in the same way as acetylcholine. Because...
Administering Oxygen by Mask
Administering oxygen by mask is a common nursing intervention that provides supplemental oxygen to patients with respiratory distress or chronic lung conditions. This procedure involves delivering oxygen at a specified rate through a face mask connected to an oxygen source.
Equipment
The equipment necessary for this procedure includes:
Endotracheal Intubation II: Nursing Management
1. Nursing Care of Patients Before Intubation
Before the endotracheal intubation procedure, nurses play an essential role in ensuring the process goes smoothly. The nurses must be familiar with intubation...
