"超越低氧症:内源性碳氧血球蛋白作为急性呼吸窘迫综合征的预后窗口"
Behrouz Jafari1, Wei Jung Hsia2, Elysse Eusebio3
1Section of Pulmonary, Critical Care and Sleep medicine, University of California, Irvine, CA, USA; Section of Pulmonary, Critical Care and Sleep medicine, Tibor Rubin VA Medical Center, Long Beach, CA, USA.
在急性呼吸窘迫综合征 (ARDS) 患者中,在第3天的高碳氧血球蛋白 (COHgb) 水平预测死亡率. 这一发现适用于COVID-19和非COVID-19的ARDS,这表明COHgb是潜在的预后生物标志物.
科学领域:
- 关键护理医学 关键护理医学
- 肺部病理学 肺部病理学
- 生物标志物 生物标志物
背景情况:
- 急性呼吸窘迫综合征 (ARDS) 是一种严重的疾病,死亡率高.
- 现有的生理标记为ARDS患者提供不完整的预后.
- 内源性碳氧血球蛋白 (COHgb) 表明血氧酶-1活性和氧化应激,可能提供预后见解.
研究的目的:
- 调查动脉中COHgb水平与ARDS患者死亡率之间的关联.
- 为了评估COHgb与重症监护室 (ICU) 和无呼吸器日的相关性.
- 为了比较COHgb的预后表现与已建立的ARDS严重性得分和氧化指数,包括COVID-19和非COVID-19ARDS.
主要方法:
- 追溯队列研究 (2017-2021),包括非吸烟成年ARDS患者 (柏林标准).
- 在预定义的ARDS时间点测量COHgb和生理参数.
- 主要结局:住院死亡率;次要结局:无ICU和无呼吸器日. 使用多变量物流回归和ROC分析.
主要成果:
- 第三天的COHgb水平在未幸存者 (1.47%) 与幸存者 (0.97%) (P=0.002) 相比显著更高.
- 第三天COHgb独立预测的死亡率 (aOR 3.15;P=0.020) 的AUC为0.70.
- 这些发现在COVID-19和非COVID-19ARDS子组中一致.
结论:
- 动脉COHgb显示出作为ARDS死亡率预后生物标志物的潜力.
- COHgb提供了独立于已建立的严重性得分和氧化指数的预后值.
- 需要进行更大规模的多中心研究来证实这些产生假设的发现.
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