病原体状态对败血症相关急性呼吸困扰综合征结果的影响
Nahui Li1, Hongfei Wang1, Lin Zhu1
1Department of Intensive Care Unit, Key Laboratory for Critical Care Medicine of The Ministry of Health, Emergency Medicine Research Institute, Tianjin First Central Hospital, Tianjin, China.
概括
有阳性致病微生物的败血症相关急性呼吸困扰综合征 (ARDS) 显示出更糟糕的结果和更高的死亡率. 在这些危急患者中,Acinetobacter baumannii感染表明预后特别差.
科学领域:
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
- 呼吸系统医学 呼吸系统医学
背景情况:
- 败血症相关的急性呼吸困扰综合征 (ARDS) 呈现出高发病率和死亡率.
- 微生物阳性和微生物阴性败血症相关的ARDS之间的特征和结果的差异尚未得到充分理解.
研究的目的:
- 为了比较与败血症相关的ARDS患者的临床特征和预后,具有阳性与阴性致病微生物结果.
- 确定与微生物阳性败血症相关的ARDS死亡的独立风险因素.
主要方法:
- 使用MIMIC IV和eICU数据库进行回顾性队列研究.
- 分析包括非参数测试,威尔科克森,单变量和多变量COX回归以及ROC曲线.
- 微生物阳性和阴性组之间的氧化指数,死亡率和风险因素的比较.
主要成果:
- 与微生物阳性败血症相关的ARDS患者表现出较差的氧化 (较低的PaO2,PaO2/FiO2,SpO2/FiO2) 和更差的预后.
- 在微生物阳性组中观察到较高的28天和90天死亡率.
- 死亡的独立风险因素包括年龄,INR,乳酸,Acinetobacter baumannii感染,CRRT和SOFA得分,A. baumannii感染表明预后特别差.
结论:
- 与症相关的ARDS与阳性致病微生物,特别是Acinetobacter baumannii有关,与预后不佳有关.
- 这些发现强调了需要及时的临床治疗和受影响患者的风险分层.
相关概念视频
Pneumonia II: Pathophysiology
230
The pathophysiology of pneumonia involves the following steps:
230
Acute Respiratory Failure-V
124
The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...
Ensure that patients are monitored continuously for their response to therapy, including changes in...
124
Pneumonia IV: Management
308
The treatment of pneumonia varies based on its severity and the causative pathogen. Here is a structured approach to managing pneumonia, integrating pharmaceutical and supportive care strategies.
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
308
Pneumonia III: Complications and Assessment
182
Pneumonia poses the potential for numerous complications that warrant consideration. These complications include the following:
182
Factors Affecting the Risk of Infection
11.5K
The hosts' susceptibility to infection depends on several factors. The integrity of the skin and mucous membranes helps protect the body against microbial attacks. When the skin is altered, the chance of infection, limb loss, and even death increases.
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
11.5K
Pneumonia I: Introduction
214
Pneumonia is an acute respiratory infection that targets the lungs, specifically the alveoli. These tiny air sacs, essential for oxygen exchange, become engorged with pus and fluid, severely hindering breathing, decreasing oxygen absorption, and causing significant pain and discomfort during respiration.
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
214


