Matta Atul, Chaudhary Siddique, Bryan Lo Kevin, DeJoy Robert, Gul Fahad, Torres Ricardo, Chaisson Neal, Patarroyo-Aponte Gabriel
Department of Pulmonary Critical Care and Sleep Medicine, Einstein Medical Center, Philadelphia, PA.
Department of Medicine, Einstein Medical Center, Philadelphia, PA.
Crit Care Explor. 2020 Oct 23;2(10):e0262. doi: 10.1097/CCE.0000000000000262. eCollection 2020 Oct.
In critically ill patients with coronavirus disease 2019, there has been considerable debate about when to intubate patients with acute respiratory failure. Early expert recommendations supported early intubation. However, as we learned more about this disease, the risks versus benefits of early intubation are less clear. We report our findings from an observational study aimed to compare the difference in outcomes of critically ill patients with coronavirus disease 2019 who were intubated early versus later in the disease course. Early need for intubation was defined as intubation either at admission or within 2 days of having a documented Fio greater than or equal to 0.5. In the final sample of 111 patients, 76 (68%) required early intubation. The mean age among those who received early intubation was significantly higher (69.79 ± 12.15 vs 65.03 ± 8.37 years; = 0.038). Also, the patients who required early intubation had significantly higher Sequential Organ Failure Assessment scores at admission (6.51 vs 3.48; ≤ 0.0001). The outcomes were equivocal among both groups. In conclusion, we suggest that the timing of intubation has no impact on clinical outcomes among patients with coronavirus disease 2019 pneumonia.
在患有2019冠状病毒病的重症患者中,对于急性呼吸衰竭患者何时进行气管插管存在相当大的争议。早期专家建议支持早期插管。然而,随着我们对这种疾病了解得更多,早期插管的风险与益处变得不那么清晰了。我们报告了一项观察性研究的结果,该研究旨在比较2019冠状病毒病重症患者在病程早期与晚期进行气管插管的结局差异。早期插管需求定义为在入院时或记录的Fio大于或等于0.5后的2天内进行插管。在111例患者的最终样本中,76例(68%)需要早期插管。接受早期插管者的平均年龄显著更高(69.79±12.15岁对65.03±8.37岁;P = 0.038)。此外,需要早期插管的患者入院时序贯器官衰竭评估评分显著更高(6.51对3.48;P≤0.0001)。两组的结局尚无定论。总之,我们建议气管插管时机对2019冠状病毒病肺炎患者的临床结局没有影响。