倾斜位置对因COVID-19相关ARDS而被输入患者的氧化参数的影响:前性观察性研究
Reva Balci Akpinar1, Ümit Karatepe2, Sümeyye Bilgili Tekin3
1Ataturk University, Faculty of Nursing, Department of Nursing Fundamentals, Erzurum, Turkey.
在急性呼吸窘迫综合征 (ARDS) 的COVID-19患者中,俯卧姿势 (PP) 显著改善了氧化和减少了肺不透明度. 这种每天16小时的干预为严重的ARDS管理提供了潜在的好处.
科学领域:
- 临界护理医学 临界护理医学
- 肺部病理学 肺部病理学
- 传染性疾病 传染性疾病
背景情况:
- 俯卧 (PP) 是一种公认的干预措施,用于改善急性呼吸困扰综合征 (ARDS) 中的氧化.
- 在机械通风的COVID-19 ARDS患者中,关于PP的疗效的证据仍然异质.
- 这项研究调查了特定的PP协议对COVID-19 ARDS的影响.
研究的目的:
- 评估每天16小时倾斜定位 (PP) 对 COVID-19 ARDS患者的氧化,通风和实验室参数的影响.
- 在这个患者队列中评估与PP相关的放射性变化.
- 为了比较接受PP和躺卧 (SP) 的患者之间的结果.
主要方法:
- 一项前性队列研究,涉及40名被直管的COVID-19 ARDS患者.
- 患者被分为PP组 (n=20) 和卧卧 (SP) 组 (n=20).
- 收集的数据包括氧化量 (PaO2 / FiO2),通风参数,血液学/生化标志物和每天的胸部X射线影像超过3天.
主要成果:
- 倾斜定位组在PaO2,PaCO2,PaO2/FiO2比率,pH,纤维素原,,血小板计数和LDH方面显著改善.
- 在第二天,PP组的氧和 (SaO2) 与SP组相比,在PP组显著更高.
- 在放射学上,PP患者的70%的地面玻璃不透明度下降,而SP患者的25%.
结论:
- 倾斜的定位似乎更有效地改善了严重ARDS的COVID-19患者的临床和氧化参数.
- 这些发现支持在管理COVID-19 ARDS时使用PP.
- 这项研究提供了指导ICU护士临床决策的证据,并加强了ARDS患者的护理方案.
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