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病房中俯卧位通气治疗新冠肺炎患者:一项回顾性研究。

Prone position in wards for spontaneous breathing Covid-19 patients: a retrospective study.

机构信息

Intensive Care Unit, Groupe Hospitalier Paris Saint-Joseph, Paris, France.

Institute for Integrative Cell Biology, Microbiology: Endotoxins, Structures and Host Response, Gif-sur-Yvette, France.

出版信息

Ir J Med Sci. 2021 Nov;190(4):1519-1522. doi: 10.1007/s11845-020-02479-x. Epub 2021 Jan 15.

Abstract

The pandemic of coronavirus disease 2019 (Covid-19) caused a large number of non-ventilated hypoxemic patients to require the use of prone position. The aim of this study is to measure the efficiency and tolerance of prone positioning in ward hypoxemic patients treated for Covid-19. This retrospective study included confirmed Covid-19 hypoxemic patients treated by at least one prone position session. Primary outcome was pulse oximetry over inspired oxygen fraction ratio (SpO/FiO) before, during, and after prone position. Secondary outcomes were failure, adverse events, and poor tolerance rate. Twenty-seven patients were included. During first, second and third sessions, SpO/FiO ratio was significantly higher during posture than before (p < 0.0001, p < 0.01, and p < 0.001 respectively). Eighteen patients were responders (defined as an improvement of SpO/FiO of more than 50) during the first posture and have a shorter length of hospital stay than non-responder patients. Failure rate was 5%, and poor tolerance and adverse events rates were 8% and 7% respectively. Our study found that prone position in wards improved alveolar exchange during posture and is well tolerated. This technique could be used in any medical ward.

摘要

2019 年冠状病毒病(COVID-19)大流行导致大量非通气性低氧血症患者需要采用俯卧位。本研究旨在测量 COVID-19 低氧血症患者在病房中接受俯卧位治疗的效果和耐受性。这项回顾性研究纳入了至少接受过一次俯卧位治疗的确诊 COVID-19 低氧血症患者。主要结局是测量俯卧位前后患者的脉搏血氧饱和度/吸氧分数(SpO/FiO)。次要结局包括失败率、不良事件和较差的耐受率。共纳入 27 例患者。在第一次、第二次和第三次治疗中,患者的 SpO/FiO 比值在体位时均显著高于体位前(p<0.0001、p<0.01 和 p<0.001)。18 例患者(定义为 SpO/FiO 比值改善超过 50%)在第一次接受俯卧位治疗时为应答者,其住院时间短于无应答者。失败率为 5%,较差的耐受率和不良事件发生率分别为 8%和 7%。本研究发现,病房中的俯卧位可改善体位时的肺泡交换,且患者耐受性良好。这种技术可以在任何医疗病房中使用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca90/7809237/abd50668f255/11845_2020_2479_Fig1_HTML.jpg

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