Critical care department, Hospital Universitario y Politécnico la Fe, Valencia, Spain.
Critical care department, Hospital Universitario y Politécnico la Fe, Valencia, Spain.
Med Intensiva (Engl Ed). 2021 Jan-Feb;45(1):27-34. doi: 10.1016/j.medin.2020.06.015. Epub 2020 Jul 11.
Information from critically ill coronavirus disease 2019 (COVID-19) patients is limited and in many cases coming from health systems approaches different from the national public systems existing in most countries in Europe. Besides, patient follow-up remains incomplete in many publications. Our aim is to characterize acute respiratory distress syndrome (ARDS) patients admitted to a medical critical care unit (MCCU) in a referral hospital in Spain.
Retrospective case series of consecutive ARDS COVID-19 patients admitted and treated in our MCCU.
36-bed MCCU in referral tertiary hospital.
SARS-CoV-2 infection confirmed by real-time reverse transcriptase-polymerase chain reaction (RT-PCR) assay of nasal/pharyngeal swabs.
None MAIN VARIABLES OF INTEREST: Demographic and clinical data were collected, including data on clinical management, respiratory failure, and patient mortality.
Forty-four ARDS COVID-19 patients were included in the study. Median age was 61.50 (53.25 - 67) years and most of the patients were male (72.7%). Hypertension and dyslipidemia were the most frequent co-morbidities (52.3 and 36.4% respectively). Steroids (1mg/Kg/day) and tocilizumab were administered in almost all patients (95.5%). 77.3% of the patients needed invasive mechanical ventilation for a median of 16 days [11-28]. Prone position ventilation was performed in 33 patients (97%) for a median of 3 sessions [2-5] per patient. Nosocomial infection was diagnosed in 13 patients (29.5%). Tracheostomy was performed in ten patients (29.4%). At study closing all patients had been discharged from the CCU and only two (4.5%) remained in hospital ward. MCCU length of stay was 18 days [10-27]. Mortality at study closing was 20.5% (n 9); 26.5% among ventilated patients.
The seven-week period in which our MCCU was exclusively dedicated to COVID-19 patients has been challenging. Despite the severity of the patients and the high need for invasive mechanical ventilation, mortality was 20.5%.
关于重症 2019 冠状病毒病（COVID-19）患者的信息有限，且在许多情况下来自与欧洲大多数国家国家公共系统不同的卫生系统方法。此外，许多出版物对患者的随访仍不完整。我们的目的是描述在西班牙一家转诊医院的医疗重症监护病房（MCCU）收治的急性呼吸窘迫综合征（ARDS）患者。
对我们的 MCCU 收治和治疗的连续 ARDS COVID-19 患者进行回顾性病例系列研究。
转诊三级医院的 36 张病床的 MCCU。
通过实时逆转录-聚合酶链反应（RT-PCR）检测鼻/咽拭子中 SARS-CoV-2 感染。
无
收集了人口统计学和临床数据，包括临床管理、呼吸衰竭和患者死亡率的数据。
研究纳入了 44 名 ARDS COVID-19 患者。中位年龄为 61.50（53.25-67）岁，大多数患者为男性（72.7%）。高血压和血脂异常是最常见的合并症（分别为 52.3%和 36.4%）。几乎所有患者都接受了（1mg/Kg/天）类固醇和托珠单抗治疗（95.5%）。77.3%的患者需要中位数为 16 天[11-28]的有创机械通气。33 名患者（97%）接受了俯卧位通气，中位数为每位患者[2-5]个疗程。13 名患者（29.5%）诊断为医院获得性感染。10 名患者（29.4%）进行了气管切开术。在研究结束时，所有患者均已从 CCU 出院，只有 2 名（4.5%）仍在住院病房。MCCU 住院时间为 18 天[10-27]。研究结束时的死亡率为 20.5%（n=9）；通气患者中为 26.5%。
我们的 MCCU 专门收治 COVID-19 患者的这七个星期极具挑战性。尽管患者病情严重，需要有创机械通气的需求很高，但死亡率仍为 20.5%。
