SARS-CoV-2 感染对在接受单肺通风治疗的患者肺内分离器的影响
Min Li1, Xianning Duan1, Jianyou Zhang1
1Department of Anesthesiology, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, China.
Journal of cardiothoracic surgery
|September 10, 2024
概括
在COVID-19感染时,肺内排气增加,并在单肺通风 (OLV) 过程中减少氧化. 在OLV下,肺内分流和氧化恢复需要更长的时间,即使是在感染后13-16周后.
科学领域:
- 肺部生理学 肺部生理学
- 麻醉学 麻醉学
- 传染病 传染病是一种传染病.
背景情况:
- 低毒性肺血管收缩 (HPV) 对于在单肺通风 (OLV) 期间管理右到左的分流至关重要.
- 在OLV期间,SARS-CoV-2感染对HPV和肺内转移的影响尚不清楚.
- 在OLV期间调查COVID-19后的肺内分流变化是必不可少的.
研究的目的:
- 在SARS-CoV-2感染后的不同时间间隔内,评估胸腔镜部分肺切除术期间肺内转移的变化.
- 为了比较有或没有SARS-CoV-2感染病史的患者的肺内分流.
主要方法:
- 80名接受胸腔镜部分肺切除的患者 (ASA等级I-II) 被根据SARS-CoV-2感染后的时间 (0,5-8,9-12,13-16周) 分成四组.
- 使用了使用普罗波福尔,雷米芬坦尼尔和西萨特拉的标准麻醉.
- 在双肺通风 (TLV) 和单肺通风 (OLV) 期间测量了放射性动脉和混合静脉血液气体,以计算肺内分流 (Qs/Qt).
- 使用多重线性回归分析来评估肺内转移和SARS-CoV-2感染之间的关联.
主要成果:
- 与TLV和OLV期间的对照人群相比,在SARS-CoV-2感染后5-16周的患者中,肺内冲刺 (Qs/Qt) 显著更高,PaO2显著更低.
- 在TLV期间,SARS-CoV-2感染是增加肺内转移的独立风险因素.
- COVID-19的严重程度和持续的症状是OLV期间肺内转移增加的独立风险因素.
结论:
- 感染SARS-CoV-2导致肺内转移增加和氧化减少.
- 虽然13-16周后在TLV时氧化得到改善,但OLV期间的肺内转移和氧化显示出延迟的恢复.
- 这些发现强调了SARS-CoV-2感染对通风-输液匹配的持续性肺部影响.
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