机械功率与重症监护病房死亡率之间的关联在韩国患者的压力控制通风中
Jae Kyeom Sim1, Sang-Min Lee2, Hyung Koo Kang3
1Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
Acute and critical care
|February 2, 2024
概括
在压力控制通风 (PCV) 中的机械功率 (MP) 与重症监护室 (ICU) 死亡率有关. 较高的MPPCV值表明风险增加,无论神经肌肉阻断剂的使用情况如何.
科学领域:
- 关键护理医学 关键护理医学
- 机械通风机械通风机械通风
- 呼吸系统生理学 呼吸系统生理学
背景情况:
- 机械功率 (MP) 是影响机械通风患者临床结果的已知因素.
- 传统的MP方程并不直接适用于接受压力控制通风 (PCV) 的患者.
- 为了解决这一局限性,已开发出PCV (MPPCV) 的简化MP方程.
研究的目的:
- 调查MPPCV与重症监护室 (ICU) 死亡率之间的关联.
- 在PCV.患者中评估简化MP方程的实用性.
主要方法:
- 机械通风第四次国际研究数据的回顾性分析.
- 使用简化的方程计算MPPCV:MPPCV = 0.098 ∙呼吸速率 ∙潮体积 ∙ (ΔPinsp + 阳性末端呼气压).
- 使用多变量逻辑回归来比较幸存者和非幸存者组之间的MPPCV,包括分析与神经肌肉阻断剂 (NMBA) 使用的相互作用.
主要成果:
- 与幸存者 (17.6 J/min) 相比,非幸存者 (26.3 J/min) 的MPPCV显著更高.
- MPPCV与ICU死亡率独立相关 (OR,1.090;95% CI,1.029-1.155).MPPCV与ICU死亡率独立相关 (OR,1.090;95% CI,1.029-1.155).MPPCV与ICU死亡率独立相关 (OR,1.090;95% CI,1.029-1.155).
- 在ICU死亡率上,MPPCV和NMBA使用之间没有发现显著的相互作用 (P=0.579).
结论:
- 在接受PCV的患者中,MPPCV是ICU死亡率的重要预测因素.
- 简化的MPPCV方程适用于PCV患者,并且在临床上具有相关性.
- 使用NMBA并不会改变MPPCV和ICU死亡率之间的关联.
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