呼吸sevoflurane在危急病的COVID-19患者:一个回顾性队列研究研究
Jose J Zaragoza1, Marco A Baez-Garcia2,3, Jose M Lomeli-Teran2,4
1Hospital H+ Queretaro, Santiago de Querétaro,Mexico.
概括
在重症COVID-19患者中,辅助吸入的塞沃弗卢兰并没有降低镇静剂剂量,但延长了机械通风和增加了抗精神病药物需求. 建议在断奶和妄想管理时谨慎使用.
科学领域:
- 关键护理医学 关键护理医学
- 麻醉学 麻醉学
- 传染性疾病 传染性疾病
背景情况:
- 在重症COVID-19患者中管理镇静药物存在挑战,原因是高度的镇静剂需求和因器官功能障碍而改变的药物代谢.
- 吸入sevoflurane提供了肺部消除镇静的替代方案,可能减少药物积累.
研究的目的:
- 为了评估吸入sevoflurane作为机械通风COVID-19患者的辅助镇静策略的疗效.
- 为了比较接受塞沃弗兰治疗的患者和仅接受静脉静止治疗的患者之间累积的静脉静止剂负担,机械通风的持续时间和抗精神病药物的使用.
主要方法:
- 一个单一中心的回顾性队列研究包括43名机械通风COVID-19患者.
- 患者被分为两组:吸入的塞沃弗卢兰作为静脉 (IV) 镇静剂的辅助 (n=30) 和单独的IV镇静剂 (n=13).
- 主要结局是7天内累积的IV镇静剂剂量;次要结局包括输出和抗精神病药物的使用时间.
主要成果:
- 在sevoflurane和对照组之间没有观察到累积IV镇静剂剂量的显著差异.
- 七黄素组经历了机械通风的平均持续时间 (206 vs 144小时) 和更高的抗精神病药物使用 (66.6% vs 15.3%).
- 虽然在sevoflurane组的某些天,每天的propofol剂量较低,但整体镇静剂负担保持不变.
结论:
- 在这个COVID-19队列中,辅助吸入的塞沃弗卢兰并没有显著降低累积的IV镇静剂负担.
- 使用西沃弗兰与延迟输出管和增加抗精神病药物需求有关.
- 研究结果表明,在使用sevoflurane治疗COVID-19患者时,需要谨慎使用镇静剂,特别是在呼吸机断奶和妄想管理方面.
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