系统性超声波查严重COVID-19的ICU患者下肢深静脉血栓症:一项随机临床试验
Carlos Ernesto Marrero Eligio De La Puente1,2, David Flota Ruiz1, Lluis Sánchez Besalduch1
1Servicio de Angiología, cirugía vascular y endovascular. Hospital Universitario Vall d'Hebron, Barcelona, Spain.
Journal of intensive care medicine
|January 22, 2025
概括
在重症COVID-19患者的深静脉血栓症 (DVT) 系统超声波查没有改善临床结果. 这项随机试验发现,与重症监护室 (ICU) 患者的标准护理相比,没有显著的益处.
科学领域:
- 关键护理医学 关键护理医学
- 血管医学 血管医学
- 传染性疾病 传染性疾病
背景情况:
- 静脉血栓栓塞 (VTE),包括肺栓塞 (PE) 和深静脉血栓塞 (DVT),是COVID-19患者的一个重大问题.
- 对这些患者在重症监护室 (ICU) 设置中进行系统VTE查缺乏明确的建议.
研究的目的:
- 在重症COVID-19患者中调查系统深静脉血栓塞 (DVT) 查的临床益处.
- 为了确定常规超声波查是否与标准护理方案相比影响患者的结果.
主要方法:
- 一个单中心随机临床试验 (RCT) 涉及入住ICU的COVID-19患者.
- 患者被随机分为两组:一组接受定期的DVT超声波 (US) 查,另一组接受标准单元协议护理的对照组.
- 主要结局是DVT存在;次要结局包括ICU停留,21天死亡率和出血并发症. 还分析了预后不佳的复合终点.
主要成果:
- 查组显示,与对照组相比,DVT的发病率 (16.7%) 较高 (3.8%),具有统计学上显著的差异 (p=0.007).
- 在肺栓塞 (PE) 的发生率或组合预后不良变量终点中没有观察到显著差异.
- 与糟糕的结果相关的因素包括男性的性别,年龄,疫苗接种情况以及纤维素素,尿素,肌素和介质素6的水平升高,以及APACHE II和SOFA分数.
结论:
- 与通常护理相比,在重症COVID-19患者中对DVT进行系统超声波查并没有导致临床结果显著改善.
- 该研究表明,在这个人群中,常规DVT查可能没有益处,并且没有降低预后不佳的复合终点.
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