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甲型H1N1流感所致急性呼吸窘迫综合征幸存者重症监护病房出院6个月后的肺弥散功能与生活质量

[Lung diffusion capacity and quality of life 6 months after discharge from the ICU among survivors of acute respiratory distress syndrome due to influenza A H1N1].

作者信息

Quispe-Laime A M, Fiore C, González-Ros M N, Bettini J E, Rolfo V E, Campagne C G, Barberio P A

机构信息

Unidad de Cuidados Intensivos, Hospital Municipal de Agudos Dr. Leónidas Lucero, Bahía Blanca, Argentina.

出版信息

Med Intensiva. 2012 Jan-Feb;36(1):15-23. doi: 10.1016/j.medin.2011.09.007. Epub 2011 Nov 25.

DOI:10.1016/j.medin.2011.09.007
PMID:22118978
Abstract

OBJECTIVE

An evaluation is made of lung function and quality of life 6 months after discharge from the Intensive Care Unit (ICU) among survivors of acute respiratory distress syndrome (ARDS) due to pandemic 2009 influenza A H1N1, based on studies of lung function and the EQ-5D health questionnaire.

DESIGN

Case series.

SETTING

The ICU of Dr. Leónidas Lucero Acute Cases Municipal Hospital, Bahía Blanca, Argentina.

PATIENTS

PATIENTS discharged from the ICU who had been admitted with ARDS in 2009 due to influenza A H1N1.

RESULTS

Eleven patients were studied. Seven were positive for influenza H1N1 and four were negative. The mean age was 37±9.5 years, and 73% were males. Quality of life, as measured by the EQ-5D, showed changes in the 5 components in all patients, particularly in the pain/discomfort dimension 1.55±0.52; health status (EQ%health) was 70%±24. The indices adjusted for Argentina were Time Trade Off (TTO) 0.903±0.085 and Visual Analog Scale (VAS) 0.827±0.153. In all patients, spirometry and the study of pulmonary diffusion (DLCO) showed values of >80%. There was no correlation between lung diffusion and quality of life (%DLCO and EQ%health). A correlation was observed between quality of life and TTO (EQ%health and TTO), and between quality of life and the VAS score (EQ%health and VAS).

CONCLUSION

Although the sample is small, our results suggest that patients with ARDS due to influenza A H1N1 evaluated 6 months after discharge from the ICU show no deterioration of lung function, and the impact on quality of life is moderate-in contrast to the situation found in patients with ARDS of other etiologies.

摘要

目的

基于肺功能研究和EQ-5D健康调查问卷,对2009年甲型H1N1流感所致急性呼吸窘迫综合征(ARDS)幸存者在重症监护病房(ICU)出院6个月后的肺功能和生活质量进行评估。

设计

病例系列研究。

地点

阿根廷布兰卡港莱昂尼达斯·卢塞罗博士市立医院急性病重症监护病房。

患者

2009年因甲型H1N1流感伴ARDS入住ICU并已出院的患者。

结果

对11例患者进行了研究。7例甲型H1N1流感检测呈阳性,4例呈阴性。平均年龄为37±9.5岁,73%为男性。通过EQ-5D测量的生活质量显示,所有患者的5个维度均有变化,尤其是在疼痛/不适维度(1.55±0.52);健康状况(EQ%健康)为70%±24。根据阿根廷情况调整后的指数为时间权衡法(TTO)0.903±0.085和视觉模拟量表(VAS)0.827±0.153。所有患者的肺量计检查和肺弥散功能(DLCO)研究显示数值均>80%。肺弥散功能与生活质量(%DLCO和EQ%健康)之间无相关性。观察到生活质量与TTO(EQ%健康和TTO)之间以及生活质量与VAS评分(EQ%健康和VAS)之间存在相关性。

结论

尽管样本量较小,但我们的结果表明,在ICU出院6个月后接受评估的甲型H1N1流感所致ARDS患者肺功能未恶化,且对生活质量的影响为中度,这与其他病因所致ARDS患者的情况形成对比。

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