临界COVID-19肥胖患者的VV-ECMO:一个队列研究
Joana Nogueira1, Ricardo Freitas2, José Eduardo Sousa2
1Intensive Care Medicine, Coimbra University Hospital Centre, Coimbra, Portugal. joananogueira94@gmail.com.
Journal of anesthesia, analgesia and critical care
|August 12, 2024
概括
较高的BMI,年轻的年龄和女性性别与肥胖的COVID-19患者在毒性体外膜氧化 (VV-ECMO) 上的更好的生存率有关. 在VV-ECMO之前的并发症和通风减少也改善了结果.
科学领域:
- 关键护理医学 关键护理医学
- 支持心肺血管的支持.
- 传染病流行病学 传染病流行病学
背景情况:
- 肥胖对体外膜氧化 (ECMO) 支持和患者的治疗结果构成挑战.
- 由于COVID-19大流行,由于严重疾病,需要ECMO的肥胖患者的数量增加.
- 了解这一群体的预后因素对于改善护理至关重要.
研究的目的:
- 在接受毒性ECMO (VV-ECMO) 的重症肥胖COVID-19患者中预测180天生存的因素.
- 分析患者特征,干预措施和生存结果之间的关联.
- 为管理VV-ECMO的肥胖患者提供见解.
主要方法:
- 在VV-ECMO.上对成年COVID-19患者 (肥胖/超重) 的单中心回顾性研究.
- 从2020年4月到2022年5月收集的数据.
- 用于评估180天死亡率的单变物流回归.
主要成果:
- 包括41名患者,他们的BMI中位数为36公斤/米2.
- 180天的死亡率为41.5%,为41.5%.
- 较高的BMI (OR 1.157,p=0.009),年轻的年龄 (OR 0.858,p=0.004),女性性别 (OR 0.074,p=0.019),较少的ECMO前通风 (OR 0.612,p=0.022),以及较少的通风并发症 (OR 0.13,p=0.022) 与更高的180天生存率有关.
结论:
- 较高的BMI,年轻的年龄和女性性别与VV-ECMO的肥胖COVID-19患者的180天生存率的改善有关.
- 在VV-ECMO之前,侵袭性通风持续时间的减少和更少的管并发症也与生存率的增加相关.
- 这些发现突出了这一高风险患者群体的关键预后指标.
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