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在严重的COVID-19相关的肺损伤患者中早期的sevoflurane镇静. 一个试点随机对照试验

Beatrice Beck-Schimmer^1,2, Erik Schadde^2,3, Urs Pietsch⁴

¹Institute of Anesthesiology, University Hospital Zurich University of Zurich, Raemistrasse 100, Zurich, CH-8091, Switzerland.

Annals of intensive care

|March 27, 2024

概括

在COVID-19患者中,席沃兰镇静并没有改善死亡率或器官功能障碍. 然而,它减少了血管压缩剂的使用,但增加了急性损伤,建议谨慎使用.

科学领域:

关键护理医学关键护理医学
麻醉学麻醉学
传染性疾病传染性疾病

背景情况:

严重的COVID-19肺损伤涉及炎症和细胞因子风暴,特别是IL-6的升高.
机械通风和镇静是这些患者的标准治疗方法.

研究的目的:

在严重的COVID-19患者中,评估挥发性镇静剂 (sevoflurane) 与静脉镇静剂的器官保护作用.
评估对死亡率,持续器官功能障碍和炎症标志物的影响.

主要方法:

一项试点多中心随机对照试验,涉及60名机械通风COVID-19患者.
患者被随机分配到48小时的西沃弗兰或持续静脉静止剂.
主要结局是28日死亡率或持续的器官功能障碍.

主要成果:

在首要结局 (死亡率或持续的器官功能障碍) 中没有显著的差异. 在sevoflurane和对照组之间.
黄素的使用与对血管压缩剂的需求显著降低 (4%与26%相比).
然而,黄显著增加了急性损伤的发生率 (39%与6%相比).

结论:

在COVID-19患者中,短期sevoflurane镇静对死亡率或持续器官功能障碍没有益处.
意想不到的低IL-6水平表明,炎症反应可能不如预期那么严重.
由于急性损伤的风险增加,在这种患者群体中使用西沃弗兰进行镇静时需要谨慎.

关键词:

麻醉条件调节麻醉条件调节与COVID-19相关的肺部损伤西沃氨酸是什么?挥发性麻醉剂是一种挥发性麻醉剂.

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