在COVID-19患者的通风策略中应用倾斜位置通风
概括
俯卧式呼吸,包括醒着俯卧式呼吸,可以改善COVID-19急性呼吸困扰综合征 (ARDS) 患者的肺功能. 建议尽早实施这些策略,以获得更好的结果.
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:
- 冠状病毒疾病2019 (COVID-19) 经常导致急性呼吸系统应急综合征 (ARDS),这是死亡的主要原因.
- 俯卧式通风 (PPV) 是一种公认的干预措施,用于管理ARDS患者.
研究的目的:
- 评估在被诊断为COVID-19的患者中倾斜位置通风策略的有效性.
- 为了比较输管倾斜位置,清醒倾斜位置和COVID-19患者的仰卧位置的结果.
主要方法:
- 对300名进入ICU的COVID-19患者进行了回顾性分析.
- 患者被分为三个组:输管倾斜位置 (n=110),清醒倾斜位置 (n=90) 和仰卧位置 (n=100).
- 临床指标包括APACHE-II分数和血液气体水平使用ANOVA和Kruskal-Wallis H测试进行了比较.
主要成果:
- 与卧卧 (P<0.05) 相比,清醒和输管倾斜的位置都显著改善了氧化 (PaO2和P/F比率).
- 清醒的倾斜姿势组在PaO2中显示出最大的改善,其次是输管倾斜姿势组.
- 输管倾斜位置组的APACHE II分数最高,表明最初的严重程度更高,而清醒倾斜位置组的APACHE II分数最低.
结论:
- 倾斜的位置通风,无论是直管或清醒,在COVID-19患者的ARDS中为肺功能提供了显著的好处.
- 早期实施倾斜位置通风策略对于管理COVID-19引起的ARDS至关重要.
相关概念视频
Mechanical Ventilation III: Noninvasive Ventilation
125
Noninvasive positive-pressure ventilation (NIPPV), continuous positive airway pressure (CPAP), and bilevel positive airway pressure (BiPAP) are essential methods in respiratory care. These ventilation techniques offer unique benefits for patients with various respiratory conditions, providing adequate support without requiring intubation. Let's explore how each method is crucial in improving patient outcomes and enhancing respiratory therapy.
Noninvasive Positive-Pressure Ventilation...
Noninvasive Positive-Pressure Ventilation...
125
Acute Respiratory Failure-V
142
The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...
Ensure that patients are monitored continuously for their response to therapy, including changes in...
142
Mechanical Ventilation I: Indication and Settings
403
Mechanical ventilation is a life-saving technique for managing acute respiratory failure and other respiratory complications. The process involves using a machine known as a ventilator to supply oxygen to the lungs and assist in removing carbon dioxide. It serves as a bridge to long-term mechanical ventilation or a temporary measure until ventilatory support is discontinued. The ventilator can maintain this function for a prolonged period, providing critical support for patients until they can...
403
Transmission-based Precautions II: Airborne and Protective Environment
1.3K
Transmission-based precautions are for patients infected or suspected to be infected (or colonized) with organisms posing a significant risk to others. The transmission precautions include airborne and protective environment precautions.
Airborne precautions:
Use airborne precautions when treating patients known or suspected to have diseases that spread through the air—for example, tuberculosis or measles. These organisms are present in smaller droplets expelled by an infected person and...
Airborne precautions:
Use airborne precautions when treating patients known or suspected to have diseases that spread through the air—for example, tuberculosis or measles. These organisms are present in smaller droplets expelled by an infected person and...
1.3K
Mechanical Ventilation II: Invasive Ventilation
152
Ventilators are essential medical equipment used to aid patients with respiratory difficulties. Their primary function is to assist or replace spontaneous breathing by providing mechanical ventilation. There are two general classes of mechanical ventilators: negative-pressure and positive-pressure ventilators.
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...
152
Oxygen Delivering System II: Venturi Mask and Transtracheal Oxygen
622
Oxygen therapy is a pivotal aspect of medical care, particularly for patients with respiratory ailments. Two prominent oxygen-delivering systems include the Venturi mask and the transtracheal oxygen catheter.
Venturi Mask
The Venturi mask, named after the Venturi effect, is designed to deliver precise oxygen concentrations. It consists of a large tube with an oxygen inlet that narrows down, causing a pressure drop that pulls air in through adjustable side ports. The mask is a lightweight,...
Venturi Mask
The Venturi mask, named after the Venturi effect, is designed to deliver precise oxygen concentrations. It consists of a large tube with an oxygen inlet that narrows down, causing a pressure drop that pulls air in through adjustable side ports. The mask is a lightweight,...
622


