Intracranial compliance in patients with COVID-19: a multicenter observational study.

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY
Accounts of Chemical Research Pub Date : 2024-09-01 Epub Date: 2024-08-09 DOI:10.1055/s-0044-1788669
Ana Flávia Silveira, Marcella Barreto Santos, Nelci Zanon Collange, Cintya Yukie Hayashi, Gustavo Henrique Frigieri Vilela, Samantha Longhi Simões de Almeida, João Brainer Clares de Andrade, Salómon Rojas, Fabiano Moulin de Moraes, Viviane Cordeiro Veiga, Uri Adrian Prync Flato, Thiago Luiz Russo, Gisele Sampaio Silva
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引用次数: 0

Abstract

Background:  Patients with severe coronavirus disease-19 (COVID-19) may require the use of invasive mechanical ventilation (MV) for prolonged periods. Aggressive MV parameters have been associated with changes in intracranial pressure (ICP) in patients with acute intracranial disorders. Significant ICP elevation could compromise intracranial compliance (ICC) and cerebrovascular hemodynamics (CVH). However, the effects of these parameters in individuals without neurological disorders have not yet been evaluated.

Objective:  To evaluate ICC in patients on MV with COVID-19 infection compared to other diagnoses, to better characterize the effects of MV and COVID-19 upon ICC. We also compared between the ICC in patients with COVID-19 who did not require MV and healthy volunteers, to assess the isolated effect of COVID-19 upon ICC.

Methods:  This was an exploratory, observational study with a convenience sample. The ICC was evaluated with a noninvasive ICP monitoring device. The P2/P1 ratio was calculated by dividing the amplitude of these two points, being defined as "abnormal" when P2 > P1. The statistical analysis was performed using a mixed linear model with random effects to compare the P2/P1 ratio in all four groups on the first monitoring day.

Results:  A convenience sample of 78 subjects (15 MV-COVID-19, 15 MV non-COVID-19, 24 non-MV-COVID-19, and 24 healthy participants) was prospectively enrolled. There was no difference in P2/P1 ratios between MV patients with and without COVID-19, nor between non-MV patients with COVID-19 and healthy volunteers. However, the P2/P1 ratio was higher in COVID-19 patients with MV use than in those without it.

Conclusion:  This exploratory analysis suggests that COVID-19 does not impair ICC.

COVID-19 患者的颅内顺应性:一项多中心观察研究。
背景:严重冠状病毒病-19(COVID-19)患者可能需要长期使用有创机械通气(MV)。在急性颅内疾病患者中,积极的机械通气参数与颅内压(ICP)的变化有关。ICP 的显著升高会损害颅内顺应性 (ICC) 和脑血管血流动力学 (CVH)。然而,这些参数对无神经系统疾病患者的影响尚未得到评估:与其他诊断相比,评估感染 COVID-19 的中风患者的 ICC,以更好地描述中风和 COVID-19 对 ICC 的影响。我们还比较了不需要 MV 的 COVID-19 患者与健康志愿者的 ICC,以评估 COVID-19 对 ICC 的单独影响:方法:这是一项探索性观察研究,采用便利样本。使用无创 ICP 监测设备评估 ICC。P2/P1 比值通过除以这两点的振幅计算得出,当 P2 > P1 时定义为 "异常"。统计分析采用随机效应混合线性模型,比较所有四组在监测首日的 P2/P1 比值:前瞻性招募了 78 名受试者(15 名 MV-COVID-19 受试者、15 名 MV 非 COVID-19 受试者、24 名非 MV-COVID-19 受试者和 24 名健康受试者)。有 COVID-19 和没有 COVID-19 的中风病人之间,以及有 COVID-19 的非中风病人和健康志愿者之间的 P2/P1 比率没有差异。然而,使用 COVID-19 的 MV 患者的 P2/P1 比率高于未使用 COVID-19 的患者:这一探索性分析表明,COVID-19 不会损害 ICC。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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