在治疗COVID-19患者中的CPAP与HFNCARDS:一项回顾性倾向匹配研究
Ivan Šitum1, Lovro Hrvoić2, Ante Erceg1
1Department of Anesthesiology, Reanimatology, Intensive Medicine and Pain Therapy University Hospital Centre Zagreb.
概括
与高流量鼻管 (HFNC) 相比,持续正气道压力 (CPAP) 非侵入性通风导致COVID-19急性呼吸困扰综合征 (ARDS) 患者的输管率降低,生存率提高. CPAP是ARDS更有效的呼吸辅助方法.
科学领域:
- 临界护理医学 临界护理医学
- 肺部病理学 肺部病理学
- 传染性疾病 传染性疾病
背景情况:
- 关于非侵入性通风 (NIV) 或高流量鼻腔管 (HFNC) 对COVID-19相关的急性呼吸困扰综合征 (ARDS) 的优越性存在相互矛盾的证据.
- 了解最佳的呼吸系统支持对于管理严重的COVID-19病例至关重要.
研究的目的:
- 为了比较HFNC与CPAP NIV在治疗COVID-19相关的ARDS中的疗效和安全性.
- 为了确定哪种呼吸支方法导致更低的输管率和更好的患者结果.
主要方法:
- 84名COVID-19 ARDS患者的回顾性队列研究 (2021年2月至2023年2月).
- 倾向性评分分析将42名接受HFNC的患者与42名接受CPAP的患者匹配起来.
- 主要结局是输管率.
主要成果:
- 输管率在HFNC组 (71.4%) 与CPAP组 (40.5%) (p=0.004) 相比,在HFNC组显著更高.
- 输管的危险比率有利于CPAP.
- 在CPAP组与HFNC组相比,观察到60天生存率的统计学上显著改善 (p=0.043).
结论:
- 在降低COVID-19 ARDS的输管率方面,CPAP NIV表现出比HFNC更高的疗效.
- 用CPAP治疗的患者经历了更好的短期生存结果.
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