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用于治疗新型冠状病毒肺炎所致继发性严重呼吸衰竭的替代持续气道正压通气方法

Alternative CPAP methods for the treatment of secondary serious respiratory failure due to pneumonia by COVID-19.

作者信息

Mateos-Rodríguez Alonso, Ortega-Anselmi Justo, Candel-González Francisco Javier, Canora-Lebrato Jesús, Fragiel-Saavedra Marcos, Hernández-Píriz Alba, Behzadi-Koocahni Navid, González-Del Castillo Juan, Pérez-Alonso Antonio, de la Cruz-Conty María Luisa, García-de Casasola Gonzalo, Marco-Martínez Javier, Zapatero-Gaviria Antonio

机构信息

Hospital de Campaña IFEMA COVID-19, Madrid, Spain.

Servicio de Urgencias Médicas de Madrid SUMMA112, Madrid, Spain.

出版信息

Med Clin (Engl Ed). 2021 Jan 22;156(2):55-60. doi: 10.1016/j.medcle.2020.09.003. Epub 2020 Dec 17.

Abstract

INTRODUCTION

The use of devices that provide continuous positive pressure in the airway has shown improvement in various pathologies that cause respiratory failure. In the COVID 19 pandemic episode the use of these devices has become widespread, but, due to the shortage of conventional CPAP devices, alternative devices have been manufactured. The objective of this study is to describe the use of these devices, as well as their efficacy.

MATERIAL AND METHODS

Data are collected from patients admitted for Pneumonia due to COVID 19 at the IFEMA Field Hospital. Data are collected from 23 patients with respiratory failure and need for ventilatory support.

RESULTS

Study carried out on a total of 23 patients, dated admission to IFEMA. Alternative CPAP was used in five patients (21.7%), while ventilatory support with a reservoir mask or Ventimask Venturi effect was used in the remaining 18 patients (78.3%). A progressive increase in saturation is observed in those patients in whom alternative CPAP was used (from 94% on average to 98% and 99% on average after 30 and 60 min with the mask, respectively), although this change was not significant (p = 0.058 and p = 0.122 respectively). No significant change in RF was observed at the beginning and end of the measurement in patients who used alternative CPAP (p = 0.423), but among those who did not use alternative CPAP (p = 0.001). A statistically significant improvement in the variable oxygen saturation / fraction inspired by oxygen is observed in patients who used alternative CPAP (p = 0.040).

CONCLUSION

The use of these devices has helped the ventilatory work of several patients by improving their oxygenation parameters. To better observe the evolution of patients undergoing this therapy and compare them with patients with other types of ventilatory support, further studies are necessary.

摘要

引言

使用能在气道中提供持续正压的设备已显示出在各种导致呼吸衰竭的病症中有所改善。在新冠疫情期间,这些设备的使用变得广泛,但由于传统持续气道正压通气(CPAP)设备短缺,已制造出替代设备。本研究的目的是描述这些设备的使用情况及其疗效。

材料与方法

从IFEMA野战医院收治的因新冠病毒肺炎入院的患者中收集数据。收集了23例呼吸衰竭且需要通气支持的患者的数据。

结果

对IFEMA收治的总共23例患者进行了研究。5例患者(21.7%)使用了替代CPAP,其余18例患者(78.3%)使用了带有储氧面罩或文丘里面罩的通气支持。在使用替代CPAP的患者中观察到饱和度逐渐增加(分别在戴面罩30分钟和60分钟后,平均从94%分别升至98%和99%),尽管这种变化不显著(p值分别为0.058和0.122)。在使用替代CPAP的患者中,测量开始和结束时呼吸频率(RF)无显著变化(p = 0.423),但在未使用替代CPAP的患者中(p = 0.001)有显著变化。在使用替代CPAP的患者中,氧饱和度/吸入氧分数这一变量有统计学显著改善(p = 0.040)。

结论

这些设备的使用通过改善氧合参数帮助了几名患者的通气工作。为了更好地观察接受这种治疗的患者的病情演变并将他们与接受其他类型通气支持的患者进行比较,有必要进行进一步研究。

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