在COVID阳性ICU患者中的表,影响和未来的干预措施
Sarah Clark1, Kristin Sheehan2, Samantha Fabian1
1Department of Otolaryngology, Wake Forest University School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC, 27157, United States.
Respiratory medicine
|November 3, 2024
概括
鼻腔氧气的使用显著增加了严重病情的COVID-19患者的表风险. 实施鼻卫生协议可以防止这种脆弱人群的鼻血.
科学领域:
- 关键护理医学 关键护理医学
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 传染性疾病 传染性疾病
背景情况:
- 鼻出血使重症患者的护理复杂化,可能阻碍非侵入性通风和鼻氧输送.
- 在COVID-19大流行期间,广泛使用高流量鼻氧 (HFNO) 使得需要了解其对该人口的表作用的影响.
- 有限的研究存在于COVID-19的危急病患者的表性特征.
研究的目的:
- 为了确定严重病情的COVID-19阳性患者中表发生率.
- 在这个患者群体中,确定与表观症相关的特定风险因素.
- 在重症监护机构中为表症提供预防策略的信息.
主要方法:
- 一个主要的学术医疗中心的回顾性观察研究.
- 2020年1月至2022年5月期间被诊断为COVID-19的重症监护室 (ICU) 患者的图表审查.
- 收集的数据包括表事件,补充氧气的持续时间和类型,以及抗凝血和抗血小板治疗的使用.
主要成果:
- 这项研究包括932名患者,表发生率为7.4%.
- 在经历了表观的患者中,78%接受了补充氧气.
- 每增加一天的鼻氧剂量,就会增加7.1% (p < .001) 的表风险 (p < .001).
- 治疗性抗凝剂和大多数抗血小板药物并没有显著增加表风险.
结论:
- 长期使用鼻腔氧气是重症COVID-19患者表症的主要危险因素.
- 标准耳鼻喉科医生建议包括鼻腔卫生,以预防表.
- 将鼻腔卫生措施整合到护理方案中可能是一个简单,具有成本效益的方法,以减少这种脆弱患者队列中的表.
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