在COVID-19患者中怀疑严重呼吸衰竭的内高血压
Marco Carbonara1, Erica Ferrari1, Tatiana Birg1
1Department of Anesthesia and Critical Care, Neuroscience Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
PloS one
|September 19, 2024
概括
评估了在机械通风治疗的COVID-19患者的神经并发症. 视神经外直径的扩大表明内压升高,受高头的影响.
科学领域:
- 神经学 神经学
- 临界护理医学 临界护理医学
- 传染性疾病 传染性疾病
背景情况:
- COVID-19可以通过病毒损伤,炎症或治疗引起神经系统症状.
- 在严重病例中,机械通风和镇静限制了神经学评估.
- 这项研究调查了呼吸道COVID-19患者的神经参与和内高血压.
研究的目的:
- 为了评估机械通风COVID-19患者的神经参与.
- 使用非侵入性方法检测内高血压的迹象.
- 探索超在神经变化中的作用.
主要方法:
- 79名机械通风成年COVID-19患者的前性观察研究.
- 多模式非侵入性神经监测:通过超声波 (美国) 进行临床检查,瞳孔反应,间多普勒 (MCA) 和视神经外直径 (ONSD).
- 还进行了头部CT扫描和后续检查.
主要成果:
- 观察到正常的瞳孔反应和MCA平均速度.
- 通过US和CT扩大的ONSD (视神经外直径) 表明内压力 (ICP) 升高.
- 增加通风减少了US-ONSD,与减少的paCO2相关;随访时ONSD正常化.
结论:
- 扩大的ONSD表明在通风COVID-19患者中增加了ICP.
- 头皮增大在升高的ICP中起着重要作用.
- 需要进一步研究ONSD在超气,通风患者的情况.
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