高PEEP/低FiO通风与COVID-19的较低死亡率有关
Robin L Goossen1, Relin van Vliet1, Lieuwe D J Bos1
1Department of Intensive Care, Amsterdam University Medical Centers, Location AMC, Amsterdam, the Netherlands.
Journal of critical care
|July 12, 2024
概括
高阳性末尾呼吸压力 (PEEP) 通风改善了冠状病毒2019急性呼吸困扰综合征 (COVID-ARDS) 患者的重症监护室 (ICU) 存活率. 这一策略还与第二波研究中的更好的二次结果有关.
科学领域:
- 关键护理医学 关键护理医学
- 肺部医学 肺部医学
- 传染性疾病 传染性疾病
背景情况:
- 对于2019年新冠肺炎 (COVID-19) 急性呼吸困扰综合征 (ARDS) 患者的最佳正极端呼吸压力 (PEEP) 策略进行了辩论.
- 现有的研究主要源自早期的流行病浪潮.
研究的目的:
- 为了评估高PEEP/低分量启发氧气 (FiO2) 呼吸对荷兰COVID-19流行病第二波患者结果的影响.
主要方法:
- 一项回顾性观察性研究包括在第二波大流行期间侵入性通风COVID-19患者.
- 根据ARDS网络表,患者被分为高PEEP或低PEEP组.
- 倾向匹配用于调整影响ICU死亡率的因素,ICU死亡率是主要结果.
主要成果:
- 这项研究分析了790名COVID-ARDS患者.
- 高PEEP通风与显着降低ICU死亡率 (22.5%对39.2%;HR 0.66 [0.46-0.96];P=0.03) 有关.
- 高PEEP也与改善的次要结果相关,倾向匹配证实了这些发现.
结论:
- 在患有COVID-ARDS的患者中,高PEEP通风显示出与加强ICU生存的关联.
- 这些发现表明,高PEEP策略在管理严重的COVID-19呼吸衰竭方面起着有益的作用.
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