动脉氧气与血液恶性瘤重症患者的死亡率之间的关联:来自国际合作网络的结果
Guillaume Dumas1,2,3, Idunn S Morris4,5,6,7, Tamishta Hensman8,9
1Interdepartmental Division of Critical Care Medicine, Sinai Health System/University Health Network, University of Toronto, Toronto, Canada.
患有血液性恶性瘤的重症患者的高氧化和过量使用氧气与更高的28天死亡率有关. 管理氧气水平可能是改善这一脆弱人群生存率的可修改因素.
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
- 呼吸系统生理学 呼吸系统生理学
背景情况:
- 患有血液性恶性瘤的患者面临高风险的危及生命的并发症.
- 高氧化和过量的氧气给药对这些患者死亡率的影响还未得到充分研究.
研究的目的:
- 调查动脉氧的部分压力 (PaO2) 与28天死亡率之间的关联.
- 为了检查高氧化和过量的氧气使用在严重疾病的血液恶性瘤患者的作用.
主要方法:
- 分析了接受呼吸器辅助治疗的三组国际患者的数据.
- 使用混合效应的考克斯模型来评估一天PaO2,过量氧气使用和28天死亡率之间的关系.
主要成果:
- 在PaO2水平和28天死亡率 (p < 0.001) 之间观察到U形关系.
- 高氧化症 (PaO2 > 100 mmHg) 和过量使用氧气与28天死亡率的增加有关 (aHR: 1.11 [1.04-1.19]).
- 亚组分析显示,高氧化血和死亡率之间存在不同的关联,取决于入院的原因.
结论:
- 暴露于高氧化和过量的氧气与血液恶性瘤的危急病患者的死亡率增加有关.
- 氧气管理策略可能是一个可修改的目标,以改善这一患者群体的结果.
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