败血症的过氧和急性肺损伤的发展,增加死亡率
Ryo Yamamoto1, Seitaro Fujishima2, Kazuma Yamakawa3
1Department of Emergency and Critical Care Medicine, Keio University School of Medicine, Tokyo, Japan ryo.yamamoto@gmail.com.
BMJ open respiratory research
|December 14, 2023
概括
严重感染的高氧水平 (过氧) 会增加ICU患者的医院死亡率. 对患有严重感染的患者来说,谨慎的氧气管理至关重要.
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:
- 超生理性氧气管理与各种疾病的不良临床结果有关.
- 过氧对严重感染死亡率的影响仍然是一个关键的临床问题.
研究的目的:
- 调查严重感染的成年患者中高氧化和住院死亡率之间的关联.
主要方法:
- 全国范围的SPICE研究对严重感染的ICU患者进行后期分析.
- 过氧症被定义为在治疗开始时的动脉部分氧气压 (PaO2) ≥300 mm Hg.
- 使用逆概率加权与倾向分数的高氧和非高氧组之间的住院死亡率的比较.
主要成果:
- 在563名患者中,49人经历过高氧化. 过氧症与增加的住院死亡率有关 (28.8%对18.8%;调整后OR为1.75).
- 患有高氧症的患者患急性肺损伤的发病率更高.
- 与败血症相关的死亡率在各组之间没有显著差异.
结论:
- 在重症感染治疗开始时,高氧 (PaO2 ≥300 mm Hg) 与ICU患者的住院死亡率较高有关.
- 精明地确定氧气输送水平对于管理严重感染至关重要.
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