Department of Anesthesiology and Reanimation, TC University of Health Sciences Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey.
Eur Rev Med Pharmacol Sci. 2022 Mar;26(6):2165-2170. doi: 10.26355/eurrev_202203_28364.
There has been an increase in intensive care applications due to respiratory failure of COVID-19 infection. Management of respiratory failure includes a range of additional interventions, including high-flow nasal oxygen, noninvasive and invasive ventilation and prone position. These interventions contain risk factors for the development of ocular complications. This study aimed to elucidate the ocular pathologies that occurred in COVID-19 patients hospitalized in the intensive care unit.
Patients who completed 24 hours in the intensive care unit were included in the study. Age, gender, duration of hospitalization before intensive care unit, comorbid diseases and APACHE 2 scores of COVID-19 patients admitted to intensive care unit were recorded. SOFA scores, presence of sedation and muscle relaxant, oxygen therapy (conventional oxygen therapy, high flow nasal oxygen therapy, noninvasive ventilation, invasive ventilation) and presence of prone position were recorded. All patients were evaluated daily for ocular findings. Routine eye care protocol was applied to all patients.
Seventy patients were followed for a total of 596 days in the intensive care unit. Pathological ocular findings were observed during hospitalization in 59 of the patients followed. The incidence of chemosis in patients who underwent IMV was significantly higher compared to other methods (p<0.001).
In this study, we observed that despite our routine eye care protocols, invasive mechanical ventilation applications predispose corneal surface damage in patients followed up in the intensive care unit with COVID-19 infection.
由于 COVID-19 感染导致呼吸衰竭,重症监护病房的应用有所增加。呼吸衰竭的治疗包括一系列其他干预措施,包括高流量鼻氧、无创和有创通气以及俯卧位。这些干预措施存在发生眼部并发症的危险因素。本研究旨在阐明 COVID-19 患者在重症监护病房住院期间发生的眼部病变。
本研究纳入了在重症监护病房完成 24 小时治疗的患者。记录了入住重症监护病房的 COVID-19 患者的年龄、性别、入住重症监护病房前的住院时间、合并症和急性生理学与慢性健康状况评分系统 2 评分。记录了 SOFA 评分、镇静和肌肉松弛剂的使用、氧疗(常规氧疗、高流量鼻氧疗、无创通气、有创通气)和俯卧位的使用情况。所有患者每天都进行眼部检查。所有患者均接受常规眼部护理。
70 例患者共在重症监护病房接受了 596 天的治疗。在 59 例接受治疗的患者中观察到了住院期间的眼部病变。与其他方法相比,接受有创机械通气的患者发生球结膜水肿的发生率显著更高(p<0.001)。
在这项研究中,我们观察到,尽管我们有常规的眼部护理方案,但 COVID-19 感染重症监护病房的患者接受有创机械通气会导致角膜表面损伤。