在COVID-19患者的自发呼吸中使用倾斜的位置
Rodrigo Cerqueira Borges1, Isadora Salvador Rocco2, Camila Botana Alves Ferreira1
1Hospital Samaritano Higienópolis, São Paulo, Brazil.
概括
在COVID-19患者中,醒着的倾向定位 (PP) 降低了ICU中的死亡率,但并没有显著降低输管率. 这种安全有效的疗法为治疗严重呼吸衰竭提供了一个有希望的方法.
科学领域:
- 关键护理医学 关键护理医学
- 肺部病理学 肺部病理学
- 传染性疾病 传染性疾病
背景情况:
- 与COVID-19相关的急性缺氧呼吸衰竭经常需要进入重症监护室 (ICU).
- 管理策略旨在减少死亡率和机械通风的需要.
- 俯卧 (PP) 是一种公认的干预措施,用于改善呼吸困难时的氧化.
研究的目的:
- 评估醒着倾斜定位 (PP) 对COVID-19的ICU患者内内管率和死亡率的影响.
- 评估作为治疗干预措施的清醒PP的安全性和有效性.
主要方法:
- 追溯队列研究涉及726名COVID-19和急性缺氧呼吸衰竭的ICU患者.
- 根据机构协议,患者接受了醒着的PP,通常与高流量鼻腔导管 (HFNC) 疗法结合.
- 收集的数据包括人口统计,并发症,疾病严重程度得分和呼吸支持参数.
主要成果:
- 清醒的俯卧姿势 (PP) 与躺卧姿势 (27.1%) 相比,与明显较低的死亡率 (13.9%) 相关.
- 两组之间在机械通风的持续时间或发生率上没有发现显著差异.
- 考克斯回归分析发现醒着PP是唯一与降低死亡率显著相关的变量 (危险比:0.55;95%CI:0.33-0.92).
结论:
- 醒着倾斜定位 (PP) 是一种安全有效的干预措施,用于重症COVID-19患者.
- 在这种患者群体中,PP显著降低了死亡率.
- 醒着的PP似乎不会降低COVID-19患者内管内输管的需要.
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