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COVID-19 患者的通气治疗和重症监护入院:系统评价。

Ventilatory therapies and Intensive Care admissions for patients with COVID-19: a systematic review.

机构信息

Nursing, Maimonides Biomedical Research Institute of Cordoba (IMIBIC)/University of Córdoba/Reina Sofia University Hospital, Córdoba, Spain.

出版信息

Eur Rev Med Pharmacol Sci. 2021 Mar;25(6):2730-2743. doi: 10.26355/eurrev_202103_25436.

Abstract

OBJECTIVE

The aim of the study was to synthesize and analyze the scientific publications related to ventilatory therapies used in patients with COVID-19 in Intensive Care Units (ICUs), the parameters of invasive mechanical ventilation prescribed for these patients, and the clinical characteristics of patients admitted to the ICU.

MATERIALS AND METHODS

A systematic review was carried out through the PubMed, Embase, Web of Science and Cochrane Library databases. Studies published up to 31/05/2020 were included if they made reference to ventilatory therapies used in ICU patients with COVID-19.

RESULTS

Qualitative analysis was performed on 30 included studies. A total sample of 48,743 patients was analyzed, of which 17.66% were admitted to ICUs, and 6.4% of these patients died. Of the patients analyzed, 44.4% required some type of respiratory support. Specifically, 12.8% of patients received invasive mechanical ventilation, while 9.7% received non-invasive mechanical ventilation, and 29.7% received high-flow nasal oxygen.

CONCLUSIONS

COVID-19 has led to a high number of ICU admissions and a challenge for ICUs is to provide the best ventilatory therapy available to patients admitted. It has been observed that the available figures for ICU admissions and the use of ventilatory therapies are similar across continents. However, the data suggest that geographic areas with higher rates of ICU admission have lower mortality rates. The lack of information in some of the clinical records limits the ability to obtain more conclusive results.

摘要

目的

本研究旨在综合分析与 COVID-19 患者 ICU 中使用的通气治疗相关的科学出版物、为这些患者规定的有创机械通气参数以及 ICU 收治患者的临床特征。

材料和方法

通过 PubMed、Embase、Web of Science 和 Cochrane Library 数据库进行系统评价。纳入截至 2020 年 5 月 31 日发表的研究,如果研究涉及 ICU 中 COVID-19 患者使用的通气治疗。

结果

对 30 项纳入研究进行了定性分析。共分析了 48743 例患者,其中 17.66%的患者收入 ICU,其中 6.4%的患者死亡。分析的患者中,44.4%需要某种类型的呼吸支持。具体来说,12.8%的患者接受了有创机械通气,9.7%的患者接受了无创机械通气,29.7%的患者接受了高流量鼻氧疗。

结论

COVID-19 导致 ICU 收治人数增加,对 ICU 提出了挑战,需要为收治的患者提供最佳的通气治疗。观察到 ICU 收治和通气治疗的可用数据在各大洲相似。然而,数据表明,ICU 收治率较高的地区死亡率较低。一些临床记录中缺乏信息限制了获得更具结论性结果的能力。

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