随着时间的推移,氧负债 (DEOx) 的变化与重症COVID-19患者的临床结果之间的关联:一项观察性研究
Eduardo Tuta-Quintero1,2, Alirio Bastidas-Goyes3,4, Henry Robayo-Amortegui1,5
1School of Medicina, Universidad de La Sabana, Chía, Colombia.
BMC pulmonary medicine
|August 8, 2025
概括
在严重的COVID-19患者中,氧气负债 (DEOx) 表明转向无氧代谢. 早期较高的DEOx水平和持续的乱预测了对机械通风的需求增加和死亡风险增加.
科学领域:
- 临界护理医学 临界护理医学
- 传染性疾病 传染性疾病
- 生理学 生理学 生理学
背景情况:
- 氧气负债 (DEOx) 量化了冲击期间的氧气不足,反映了由于氧气供应减少而导致的无氧代谢.
- 严重的COVID-19与显著的生理障碍有关,包括氧气利用能力受损.
研究的目的:
- 在严重的COVID-19患者中分析DEOx值的时间变化.
- 调查DEOx与侵入性机械通风 (IMV) 的要求之间的关联.
- 确定该患者群体中DEOx和生存结果之间的关系.
主要方法:
- 对597名已成年ICU患者进行了回顾性队列研究,确认了SARS-CoV-2感染.
- 使用基于乳酸盐 (DEOx1) 和基于乳酸盐加余 (DEOx2) 的公式计算DEOx.
- 在多个时间点 (≤6小时,6-12小时,12-24小时,>24小时) 评估的DEOx变化,与IMV和生存相关.
主要成果:
- 在7日需要IMV的患者中,6小时内DEOx值显著更高 (p=0.004对于DEOx1,p=0.027对于DEOx2).
- 在不同时间点 (≤6小时,6-12小时,>24小时) 的较高DEOx值与死亡率显著相关 (多次比较时p<0.001).
- 这些关联在第14天和第28天持续存在,表明非幸存者的新陈代谢障碍持续存在.
结论:
- 脱氧变异性是重症COVID-19患者IMV需求和死亡率的重要预测因素.
- 早期升高的DEOx (≤6h) 和持续的代谢障碍 (>24h) 与更糟糕的临床结果相关.
- DEOx作为一个有价值的生物标志物,用于评估疾病严重程度和预后在严重的COVID-19.
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