倾斜的位置与机械通风的COVID-19患者的胰岛素需求增加有关
Harry Griffiths1, Amy Cardwell2, Max Richardson3
1John Farman Intensive Care Unit, Addenbrooke's Hospital, Cambridge, UK.
Scientific reports
|November 12, 2024
概括
在危急的COVID-19患者中,倾斜的定位改善了氧化,但意外地增加了胰岛素需求. 血糖控制保持稳定,表明容易通风是安全的血糖管理.
科学领域:
- 关键护理医学 关键护理医学
- 内分泌学 在内分泌学.
- 肺部病理学 肺部病理学
背景情况:
- 压力高血糖症在严重疾病中很常见,特别是在COVID-19中.
- 增加的胰岛素需求与严重的COVID-19中呼吸衰竭严重程度相关.
- 缺氧直接影响胰岛素的作用,这表明氧化变化可能会影响葡萄糖代谢.
研究的目的:
- 评估倾斜定位对COVID-19患者胰岛素敏感性和低血糖风险的影响.
- 在易于机械通风的过程中评估血糖和胰岛素需求的变化.
主要方法:
- 追溯的多中心服务评估.
- 在155名COVID-19肺炎患者中,在倾斜定位前后比较了16小时的时间.
- 监测血糖和胰岛素的管理.
主要成果:
- 仰卧的位置显著改善了氧化 (SpO2 / FiO2).
- 血糖控制在卧卧和倾斜时是相似的;在倾斜通风时没有发生低血糖症.
- 意想不到的是,胰岛素需求在易于通风的过程中增加了适度但显著 (P < 0.001).
结论:
- 倾向于通风是安全的关于危急的COVID-19的血糖控制.
- 在俯卧姿势时改善的氧化与增加的胰岛素需求有悖论的关联.
- 鉴定出了呼吸位置和危急疾病中的胰岛素需求之间的新关系.
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