患有呼吸器相关肺炎的COVID-19患者的预后因素:单中心体验
Hilal Ekici1, Seda Zor-Çakıllı1, Emine Arman-Fırat2
1Infectious Diseases and Clinical Microbiology Clinic, Yozgat City Hospital, Yozgat, Türkiye.
Infectious diseases & clinical microbiology
|July 14, 2025
概括
皮质类固醇的使用,包括甲基普雷迪尼索隆,与机械通风COVID-19患者的14天生存率更好有关. 免疫抑制剂在患有呼吸器相关肺炎 (VAP) 的患者中更为常见.
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
- 肺部病理学 肺部病理学
背景情况:
- 冠状病毒疾病2019 (COVID-19) 可能导致严重的呼吸系统疾病,包括急性呼吸系统应急综合征 (ARDS).
- 机械呼吸的患者有高风险患呼吸器相关肺炎 (VAP),这是一个严重的并发症.
- 了解VAP的风险因素及其对COVID-19患者死亡率的影响对于改善结果至关重要.
研究的目的:
- 在机械呼吸的COVID-19患者中识别呼吸器相关肺炎 (VAP) 的风险因素.
- 评估VAP对该患者群体14天死亡率的影响.
- 探索皮质类固醇使用与生存之间的关联.
主要方法:
- 在2020年7月至2021年7月期间,对在重症监护室 (ICU) 接受机械呼吸的311名COVID-19患者进行了回顾性研究.
- 评估人口统计数据,并发病,免疫抑制治疗,抗菌疗法和实验室值.
- 在VAP病例中分析病原体识别和抗菌素耐药性模式.
主要成果:
- 高血压是最常见的并发症 (48.6%).
- 较高的皮质类固醇使用 (甲基普雷迪尼索隆,德克萨米他) 和脉冲类固醇治疗与14天生存率的改善有关.
- 免疫抑制剂在患有VAP的患者中更为普遍.
- 最常见的病原体是Acinetobacter baumannii (62.5%),对抗生素具有很高的耐药性,包括卡巴.
结论:
- 皮质类固醇治疗似乎与机械通风COVID-19患者的14天生存率的改善有关.
- 免疫抑制剂的使用可能会增加VAP发展的风险.
- 需要针对COVID-19患有VAP风险的患者量身定制的治疗策略,考虑到免疫抑制疗法的潜在影响.
更多相关视频
相关概念视频
Factors Affecting Pulmonary Ventilation
1.6K
Besides the pressure difference between the external environment and the lungs, the airflow rate and ease of pulmonary ventilation are also influenced by three other factors: surface tension of the fluid in the alveoli, compliance of the lungs, and airway resistance.
Alveolar Surface Tension
The alveolar fluid lines the luminal surface of the alveoli and exerts a force called surface tension. This force is caused by the polar water molecules in the liquid being more strongly attracted to each...
Alveolar Surface Tension
The alveolar fluid lines the luminal surface of the alveoli and exerts a force called surface tension. This force is caused by the polar water molecules in the liquid being more strongly attracted to each...
1.6K
Pneumonia III: Complications and Assessment
450
Pneumonia poses the potential for numerous complications that warrant consideration. These complications include the following:
450
Pneumonia I: Introduction
338
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...
338
Pneumonia IV: Management
454
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:
454
Pneumonia II: Pathophysiology
585
The pathophysiology of pneumonia involves the following steps:
585
Pneumonia V: Nursing management and Prevention
2.5K
Nursing management of pneumonia involves promoting airway patency, facilitating rest and conserving energy, encouraging fluid intake, maintaining nutrition, and educating patients.
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
2.5K


