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新型冠状病毒肺炎所致急性呼吸窘迫综合征——一项多中心观察性研究

COVID-19 Induced Acute Respiratory Distress Syndrome-A Multicenter Observational Study.

作者信息

Herrmann Johannes, Adam Elisabeth Hannah, Notz Quirin, Helmer Philipp, Sonntagbauer Michael, Ungemach-Papenberg Peter, Sanns Andreas, Zausig York, Steinfeldt Thorsten, Torje Iuliu, Schmid Benedikt, Schlesinger Tobias, Rolfes Caroline, Reyher Christian, Kredel Markus, Stumpner Jan, Brack Alexander, Wurmb Thomas, Gill-Schuster Daniel, Kranke Peter, Weismann Dirk, Klinker Hartwig, Heuschmann Peter, Rücker Viktoria, Frantz Stefan, Ertl Georg, Muellenbach Ralf Michael, Mutlak Haitham, Meybohm Patrick, Zacharowski Kai, Lotz Christopher

机构信息

Department of Anesthesiology and Critical Care, University Hospital Würzburg, Julius-Maximilians-University Würzburg, Würzburg, Germany.

Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Goethe-University, Frankfurt, Germany.

出版信息

Front Med (Lausanne). 2020 Dec 18;7:599533. doi: 10.3389/fmed.2020.599533. eCollection 2020.

Abstract

Proportions of patients dying from the coronavirus disease-19 (COVID-19) vary between different countries. We report the characteristics; clinical course and outcome of patients requiring intensive care due to COVID-19 induced acute respiratory distress syndrome (ARDS). This is a retrospective, observational multicentre study in five German secondary or tertiary care hospitals. All patients consecutively admitted to the intensive care unit (ICU) in any of the participating hospitals between March 12 and May 4, 2020 with a COVID-19 induced ARDS were included. A total of 106 ICU patients were treated for COVID-19 induced ARDS, whereas severe ARDS was present in the majority of cases. Survival of ICU treatment was 65.0%. Median duration of ICU treatment was 11 days; median duration of mechanical ventilation was 9 days. The majority of ICU treated patients (75.5%) did not receive any antiviral or anti-inflammatory therapies. Venovenous (vv) ECMO was utilized in 16.3%. ICU triage with population-level decision making was not necessary at any time. Univariate analysis associated older age, diabetes mellitus or a higher SOFA score on admission with non-survival during ICU stay. A high level of care adhering to standard ARDS treatments lead to a good outcome in critically ill COVID-19 patients.

摘要

因新型冠状病毒肺炎(COVID-19)死亡的患者比例在不同国家有所不同。我们报告了因COVID-19诱发的急性呼吸窘迫综合征(ARDS)而需要重症监护的患者的特征、临床病程及转归。这是一项在德国五家二级或三级护理医院开展的回顾性观察性多中心研究。纳入了2020年3月12日至5月4日期间在任何一家参与研究的医院中因COVID-19诱发ARDS而连续入住重症监护病房(ICU)的所有患者。共有106例ICU患者接受了针对COVID-19诱发ARDS的治疗,而大多数病例存在重度ARDS。ICU治疗的生存率为65.0%。ICU治疗的中位持续时间为11天;机械通气的中位持续时间为9天。大多数接受ICU治疗的患者(75.5%)未接受任何抗病毒或抗炎治疗。16.3%的患者使用了静脉-静脉(vv)体外膜肺氧合(ECMO)。任何时候都无需进行基于人群水平决策的ICU分诊。单因素分析显示,年龄较大、患有糖尿病或入院时序贯器官衰竭评估(SOFA)评分较高与ICU住院期间死亡相关。严格遵循标准ARDS治疗的高水平护理可使重症COVID-19患者获得良好转归。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5edf/7775385/b0cb1c97c9a2/fmed-07-599533-g0001.jpg

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