无创通气是所有重症COVID-19患者的好选择吗?队列回顾性研究。

Q3 Medicine
Tanaffos Pub Date : 2024-02-01
Ramin Sami, Babak Amra, Forogh Soltaninejad, Zohre Naderi, Marjan Mansourian, Mina Nickpour, Media Babahajiani, Marzieh Hashemi
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引用次数: 0

摘要

背景:最近爆发的2019冠状病毒(COVID-19)是由急性呼吸综合征冠状病毒2引起的呼吸系统疾病。在疫情开始时,早期插管是管理COVID-19引起的急性呼吸窘迫综合征的最佳策略。几种对中重度COVID-19患者进行呼吸支持的非侵入性方法可以减少插管、疾病严重程度、呼吸机使用和在重症监护病房(ICU)的住院时间。本研究比较了NIV治疗失败和成功的COVID-19患者的特征。材料和方法:本描述性分析研究在霍尔什德大学医院COVID-19中心进行。患者年龄为18岁,确诊为COVID-19,于2021年1月初至3月底在ICU住院。尽管他们接受了15l的氧气储备面罩,并接受了无创通气(NIV)治疗,但他们的血氧水平仍< 88%。数据收集包括患者的人口统计信息、生命体征和入院时的检查结果,并使用APACHE、SAPS和SOFA评分评估疾病严重程度。将患者分为反应者(R)和无反应者(NR),以确定无创通气(NIV)成功的预测因素,并根据设备耐受性和生命体征变化进行随访。结果:71例NIV候选病例。本研究排除20例患者,纳入51例患者。其中,35例患者出现NIV治疗失败(NR)。另一方面,16例(31.4%)患者在接受NIV (R)治疗后完全康复并出院。结论:接受NIV治疗的COVID-19患者血清白蛋白和BMI水平似乎影响其对治疗的反应。因此,建议在NIV开始前评估患者的营养状况。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Is Non-Invasive Ventilation a Good Choice in All Patients with Severe COVID-19? A Cohort Retrospective Study.

Background: The recent outbreak of Coronavirus 2019 (COVID-19) is a respiratory disorder caused by the Acute Respiratory Syndrome Coronavirus 2. At the start of the epidemic, early intubation was the optimal strategy for managing ARDS caused by COVID-19. Several non-invasive methods for respiratory support in patients with moderate to severe COVID-19 may reduce intubation, disease severity, ventilator use, and hospitalization in the intensive care unit (ICU). In this study, the characteristics of COVID-19 patients who failed NIV therapy were compared with those who had successful NIV.

Materials and methods: The present descriptive-analytical study was conducted at the COVID-19 center of KHORSHID University Hospital. Patients were aged > 18 years with confirmed COVID-19 and hospitalized in the ICU from the beginning of January to the end of March 2021. They had an oxygen level of < 88% despite receiving 15 L of oxygen with reserve masks and were undergoing non-invasive ventilation (NIV) treatment. Data collection included patients' demographic information, vital signs, and test results upon hospital admission, and assessed disease severity using APACHE, SAPS, and SOFA scores. Patients were categorized into responders (R) and non-responders (NR) to determine predictors of non-invasive ventilation (NIV) success, with follow-up based on device tolerance and changes in vital signs.

Results: 71 Individuals were candidates for NIV. Twenty patients were excluded from the study, and 51 patients were included in the study. Of these, 35 patients underwent NIV treatment failure (NR). On the other hand, 16 (31.4%) patients completely recovered after receiving NIV (R) and they were discharged from the ICU.

Conclusion: Serum Albumin and BMI levels of COVID-19 patients undergoing NIV therapy seem to affect their responses to treatment. Hence, it is recommended to evaluate the nutritional status of patients before the start of NIV .

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Tanaffos
Tanaffos Medicine-Critical Care and Intensive Care Medicine
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