在ICU中移动的障碍:从严重的COVID-19的洞察力和改善患者结果的影响
Irene Kalbian1, Andrew Delgado2, Sofia Barchuk1
1Icahn School of Medicine at Mount Sinai Hospital, Department of Rehabilitation and Human Performance, New York, NY.
严重的COVID-19严重影响重症监护室 (ICU) 的流动性,患者的流动性明显低于非COVID同行. 这凸显了改善镇静和动员策略的必要性,以防止长期并发症.
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
- 康复医学 康复医学 康复医学
背景情况:
- 严重的COVID-19对重症监护室 (ICU) 内的患者流动性构成重大挑战.
- 与非COVID患者相比,了解重症COVID-19患者的流动性结果对于优化护理至关重要.
- 预先存在的因素和严重疾病的严重程度影响了ICU环境中的流动性.
研究的目的:
- 为了比较严重的COVID-19患者与非COVID重症患者在ICU停留期间的流动性结果.
- 确定影响重症患者移动状态的因素.
主要方法:
- 一项回顾性,单中心病例控制研究分析了2019年4月至2020年7月的3275例ICU病例.
- 在ICU访问层面进行了分析,匹配了COVID-19和非COVID队列.
- 主要结局是最高的ICU流动状态 (不移动,非流动,流动);次要结局包括临床和人口因素.
主要成果:
- COVID-19的ICU访问被压倒性地归类为不移动 (93%不太可能是门诊 vs 不移动).
- 在COVID-19患者中,APACHE-III得分更高,住院时间更长,镇静增加和更容易出现.
- 与非COVID患者相比,COVID-19患者的物理治疗访问量较少.
结论:
- 与非COVID严重疾病相比,严重的COVID-19显著降低了ICU的流动性.
- 迫切需要新的镇静和ICU动员策略,以对抗ICU获得的虚弱和重症监护后综合征.
- 解决移动性缺陷对于改善所有重症患者的治疗结果和为未来的流行病做好准备至关重要.
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