用血交换治疗的重症患者的不良事件和传染性并发症:为期五年的多中心队列研究
Mickael François1, Delphine Daubin1, Dehbia Menouche2
1Intensive Care Medicine Department, Lapeyronie University Hospital, Montpellier, France.
Critical care explorations
|February 2, 2024
概括
重症患者的治疗性血交换 (TPE) 有中度不良事件,但感染性并发症,如呼吸机相关的肺炎是常见的. 机械通风和更长的ICU停留增加了感染风险.
科学领域:
- 关键护理医学 关键护理医学
- 血液学 血液学 血液学
- 传染性疾病 传染性疾病
背景情况:
- 治疗性血交换 (TPE) 用于各种危急情况.
- 了解与TPE相关的不良事件和感染风险对于患者管理至关重要.
研究的目的:
- 确定在重症患者中TPE期间不良事件的发生率.
- 确定TPE后的二次感染的发生率及其预测因素.
主要方法:
- 在法国四所大学医院进行了一项多中心回顾性队列研究.
- 分析了124名成人患者的数据,这些患者在2015年至2019年期间至少接受了一次TPE治疗.
- 收集和分析了不良事件和传染性并发症.
主要成果:
- 治疗性血交换 (TPE) 在124名患者中进行了711次.
- 不良事件包括动脉低血压 (21%),发烧 (12%) 和电解质干扰 (9%).
- 感染性并发症发生在48%的患者中,呼吸器相关的肺炎是最常见的 (42例). 感染的独立风险因素是机械通风 (HR: 16.2) 和更长的ICU停留 (HR: 1.09).
结论:
- 在重症患者中TPE期间发生的不良事件是中度频繁的,通常不会危及生命.
- 传染性并发症,特别是与呼吸机相关的肺炎,是这一群体的一个重大问题.
- 机械通风和长时间的ICU停留时间与TPE后感染的风险更高有关.
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