Saberon Keith Moon Q, Rosario Soliven Jo-Ann
Department of Neurology, The Medical City, Ortigas Avenue, Pasig, Philippines.
Neurol Res Int. 2022 Jun 21;2022:6348888. doi: 10.1155/2022/6348888. eCollection 2022.
There has been an increasing incidence of stroke cases among SARS-CoV-2 (COVID-19) patients who were deeply sedated and underwent proning positioning. We reviewed the association of proning and sedations used to the development of stroke, including demographic profiles of patients with COVID-19 infection in the critical care unit. There was a significant association seen among COVID-19 patients in the ICU who underwent proning to the development of stroke, with up to 15 times risk of having stroke ( value = 0.007) than those who were not proned during their course of ICU stay. Patients who were given propofol and fentanyl as sedation during proning for more than 24 hours was significantly associated with the development of stroke ( value = 0.004). Patient risk factors were also studied (age variability, hypertension, diabetes, smoking, and alcoholism) and showed that patients who were alcoholic beverage drinkers were significantly associated to the development of stroke during proning ( value = <0.001). The usual risk factors for stroke in the general population (hypertension, diabetes, and cigarette smoking) were not associated with stroke development during proning, strengthening the fact that proning during COVID-19 infection is an independent risk factor for the development of stroke thus needing stroke surveillance during the duration of proning.
在深度镇静并接受俯卧位通气的严重急性呼吸综合征冠状病毒2(SARS-CoV-2,即新型冠状病毒肺炎)患者中,中风病例的发生率一直在上升。我们回顾了俯卧位通气和所使用的镇静措施与中风发生之间的关联,包括重症监护病房中新型冠状病毒肺炎感染患者的人口统计学特征。在重症监护病房中接受俯卧位通气的新型冠状病毒肺炎患者与中风的发生之间存在显著关联,其患中风的风险比在重症监护病房住院期间未接受俯卧位通气的患者高15倍( 值=0.007)。在俯卧位通气期间接受丙泊酚和芬太尼镇静超过24小时的患者与中风的发生显著相关( 值=0.004)。我们还研究了患者的风险因素(年龄差异、高血压、糖尿病、吸烟和酗酒),结果显示,饮酒者在俯卧位通气期间与中风的发生显著相关( 值=<0.00)。普通人群中常见的中风风险因素(高血压、糖尿病和吸烟)与俯卧位通气期间的中风发生无关,这进一步证明,新型冠状病毒肺炎感染期间的俯卧位通气是中风发生的独立风险因素,因此在俯卧位通气期间需要进行中风监测。