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意大利一家中级呼吸重症监护病房中 COVID-19 患者的双水平和持续气道正压通气与全因死亡率的相关因素。

Bilevel and continuous positive airway pressure and factors linked to all-cause mortality in COVID-19 patients in an intermediate respiratory intensive care unit in Italy.

机构信息

Institute of Respiratory Disease, Department of Basic Medical Science, Neuroscience, and Sense Organs, University of Bari "Aldo Moro", Bari, Italy.

Azienda Universitaria Ospedaliera Consorziale, General Director Office, Policlinico Bari, Italy.

出版信息

Expert Rev Respir Med. 2021 Jun;15(6):853-857. doi: 10.1080/17476348.2021.1866546. Epub 2020 Dec 23.

Abstract

: In the present single-centered, retrospective, observational study, we reported findings from 78 consecutive laboratory-confirmed COVID-19 patients with moderate-to-severe acute respiratory distress syndrome (ARDS) hospitalized in an intermediate Respiratory Intensive Care Unit, subdividing the patients into two groups according to their clinical outcome, dead patients and discharged patients.: We further subdivided patients depending on the noninvasive respiratory support used during hospitalization.: In those patients who died, we found significant older age and higher multimorbidity and higher values of serum lactate dehydrogenase, C-reactive protein, and D-dimer. Among patients who were submitted to bilevel positive airway pressure (BPAP), those who died had a significant shorter number of days in overall length of stay and lower values of arterial oxygen partial pressure to fractional inspired oxygen ratio (PaO2/FiO2 ratio) compared to those who survived. No difference in all-cause mortality was observed between the two different noninvasive respiratory support groups [48% for continuous positive airway pressure (CPAP) and 52% for BPAP].: In COVID-19 patients with moderate-to-severe ARDS using BPAP in an intermediate level of hospital care had more factors associated to all-cause mortality (shorter length of stay and lower baseline PaO2/FiO2 ratio) compared to those who underwent CPAP.

摘要

: 在这项单中心、回顾性、观察性研究中,我们报告了在中级呼吸重症监护病房住院的 78 例经实验室确诊的 COVID-19 合并中重度急性呼吸窘迫综合征(ARDS)患者的研究结果。根据患者的临床转归,将患者分为死亡组和出院组。: 我们根据患者住院期间使用的非侵入性呼吸支持方式进一步进行了分组。: 在死亡患者中,我们发现年龄较大、合并症较多、血清乳酸脱氢酶、C 反应蛋白和 D-二聚体水平较高。在接受双水平气道正压通气(BPAP)的患者中,与存活患者相比,死亡患者的总住院天数明显缩短,动脉血氧分压与吸入氧分数比值(PaO2/FiO2 比值)较低。两种不同的非侵入性呼吸支持方式(CPAP 和 BPAP)之间的全因死亡率无差异[CPAP 组为 48%,BPAP 组为 52%]。: 在中等级别医院护理中使用 BPAP 的 COVID-19 合并中重度 ARDS 患者与接受 CPAP 的患者相比,与全因死亡率相关的因素更多(住院时间更短,基线 PaO2/FiO2 比值更低)。

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