针对COVID-19患者的结论 接受了带有或没有体外膜氧化器 (ECMO) 的气管切除术
Karim Asi1, Daniel Gorelik2, Tariq Syed2
1Department of Otorhinolaryngology - Head and Neck Surgery, McGovern Medical School at UTHealth Houston, Houston, USA.
Cureus
|April 8, 2024
概括
在COVID-19急性呼吸窘迫综合征 (ARDS) 患者的气管切口前,体外膜氧化 (ECMO) 管与更糟糕的结果有关,包括更高的死亡率. 需要进一步的研究来指导管理策略.
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
- 心血管工程 心血管工程
背景情况:
- 随着COVID-19大流行,急性呼吸困难综合征 (ARDS) 的毒性体外膜氧化 (VV-ECMO) 使用增加了.
- 气管切除术通常是为了减轻长期内内管管道输入的风险而进行的,但它对ECMO患者的益处仍在争论中.
研究的目的:
- 为了调查体外膜氧化 (ECMO) 管道时间相对于气管切除术对COVID-19 ARDS患者结果的影响.
主要方法:
- 24名COVID-19 ARDS患者进行气管切除术的回顾性图表审查.
- 患者被分为两组:ECMO管在气管切除术前与非ECMO管.
- 统计分析包括费舍尔的精确测试和威尔科克森的等级总和测试.
主要成果:
- 在气管切除术前进行ECMO管道治疗的患者体验到更长的输管时间 (7天 vs. 3天) 和更高的多次输管率 (54% vs. 9%).
- 在 ECMO-before-tracheostomy 组中,术后出血增加 (62%对18%) 和死亡率显著上升 (39%对0%).
结论:
- 在COVID-19 ARDS患者中,气管切口前的ECMO管道与不良结果有关.
- 观察到的较差结果可能反映出这些患者的潜在疾病严重程度更大.
- 需要进一步的研究来澄清这种关系,并为临床实践提供信息.
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