镇痛,镇静和神经肌肉阻断剂:在COVID-19中进行镇痛的标准化方案
Cecilia Inés Loudet1, Marisol García Sarubbio2, María Julia Meschini2
1Applied Pharmacology Department, Faculty of Medical Sciences, National University of La Plata, Argentina; Intensive Care Unit, Hospital Interzonal General de Agudos General San Martín, La Plata, Argentina.
Medicina intensiva
|June 1, 2025
概括
轻度镇静和非二胺类药物改善了机械通风COVID-19患者的结果. 更深的镇静与更低的生存率有关,强调了ABCDEF捆绑在重症监护中的重要性.
科学领域:
- 关键护理医学 关键护理医学
- 药理学 药理学是指药理学的学科.
- 传染性疾病 传染性疾病
背景情况:
- 机械通风 (MV) 和疼痛静止对于管理严重的COVID-19至关重要.
- 标准化镇静方案,如ABCDEF捆绑,旨在优化患者护理.
- 在重症监护室 (ICU) 中,有限的员工数量和高患者敏度带来了挑战.
研究的目的:
- 评估机械通风COVID-19患者的止痛药物使用,剂量和持续时间.
- 为了比较幸存者和非幸存者之间的镇静策略.
- 在这个患者群体中确定医院死亡率的预测因素.
主要方法:
- 成年COVID-19患者的回顾性队列研究,需要侵入性MV和持续的疼痛静止治疗.
- 对镇静水平 (RASS) 的分析,药物利用 (芬太尼,米达佐拉姆,NMBAs,普罗波,德克斯米德托米丁) 和每日剂量.
- 在幸存者和非幸存者之间比较结果和死亡率预测因素.
主要成果:
- 中位数RASS为-4.5;更深的镇静与更低的存活率相关.
- 芬太尼 (99%) 和米达佐拉姆 (97%) 是最常见的;NMBA在81%使用.
- 在幸存者中,非二胺镇静剂的发生率更高 (88%对53%). 死亡率为63%;预测因素包括APACHE II,SOFA24,查尔森得分,RASS和非二胺使用.
结论:
- 标准化协议,包括轻度镇静和ABCDEF捆绑,有效地管理了重症COVID-19患者的镇静.
- 镇静深度和非二胺使用是更好的结果的独立预测因素.
- 尽管面临人员挑战,但适当的疼痛静止和NMBA使用至关重要.
关键词:
在ARDS中,我们使用ARDS.阻断神经肌肉的代理人止痛药是一种止痛药.在COVID-19大流行中,关键的护理关键的护理关心的批评者.药物是一种止痛药.准则 准则 准则 准则旅行指南 (Guías Guías)神经肌肉阻断剂是一种神经肌肉阻断剂.在COVID-19的全球流行中.协议 协议 协议 协议协议 协议 协议 协议SDRA SDRA SDRA SDRA SDRA SDRA SDRA SDRA SDRA SDRA SDRA SDRA SDRA SDRA SDRA SDRA SDRA SDRA SDRA SDRA SDRA SDRA SDRA SDRA SDRA SDRA SDRA SDRA SDRA SDRA SDRA SDRA SDRA SDRA SDRA坐着的人座座椅.镇静剂 镇静剂是一种镇静剂.更多相关视频
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