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由于COVID-19的ARDS患者的最佳倾斜位置持续时间:蛋糕试点试验

Ignacio Sáez de la Fuente¹, Adrián Marcos Morales², Reyes Muñoz Calahorro²

¹Department of Critical Care Medicine, Hospital Universitario 12 de Octubre, Madrid, Spain Ignacio.saez@salud.madrid.org.

Respiratory care

|March 26, 2024

概括

长时间躺卧 (PP) 并没有改善严重的COVID-19 ARDS患者的无呼吸器日. 延长PP增加了ICU停留时间,神经肌肉阻断剂的使用和肌肉损伤,这表明它不优于标准护理.

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
传染性疾病传染性疾病

背景情况:

俯卧 (PP) 是一种关键的干预措施,用于管理COVID-19患者的急性呼吸困扰综合征 (ARDS).
对于PP会话的最佳持续时间仍然是临床辩论的主题.
这项研究调查了长期与标准PP持续时间在严重的COVID-19ARDS中的影响.

研究的目的:

为了比较长时间 (48小时) 与标准 (~16小时) 易感定位在严重的COVID-19 ARDS中的疗效.
评估不同PP持续时间对无呼吸器日 (VFD) 和其他临床结果的影响.

主要方法:

一个单中心,随机控制的试验试验,涉及严重COVID-19 ARDS机械通风的成年患者.
患者被随机分配到长期PP组 (48小时) 或标准PP组 (~16小时).
主要结局是无呼吸器日 (VFDs) 到28日.

主要成果:

在标准PP组 (18VFD) 和长期PP组 (7.5VFD) 之间没有观察到28天VFD的显著差异.
长时间的PP与成功输出管的时间更长 (13天 vs 8天),更长的ICU停留时间 (18.5天 vs 11.5天) 和增加神经肌肉阻断剂的使用时间 (12.5天 vs 5天) 相关.
长期PP组中发现了显著的肌肉损伤,医学研究委员会较低的得分表明了这一点.

结论:

长时间的倾向性定位 (48小时) 与标准PP (~16小时) 相比,对于严重的COVID-19 ARDS,对于28天的VFDs,并没有提供优越的结果.
延长PP持续时间与不良影响有关,包括长时间的ICU住院,增加神经肌肉阻断剂的使用,以及更大的肌肉损伤.
这些发现表明,在这种患者群体中长期应用并不能改善目前对PP持续时间的护理标准.

关键词:

在ARDS中,我们使用ARDS.在ICU中,医生会对患者进行治疗.新冠病毒疾病2019年机械通风机械通风机械通风在俯卧的位置上.呼吸衰竭是指呼吸系统的衰竭.

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