de Miguel-Balsa Eva, Blasco-Ruso Teresa, Gómez-Medrano Norma, Mirabet-Guijarro María, Martínez-Pérez Alba, Alcalá-López Adoración
Servicio de Medicina Intensiva, Hospital General Universitario de Elche, Elche, Alicante, España.
Departamento de Medicina Clínica, Facultad de Medicina, Universidad Miguel Hernández de Elche, Elche, Alicante, España.
Med Intensiva. 2023 Mar 13. doi: 10.1016/j.medin.2023.03.002.
To describe the characteristics of patients with acute respiratory distress syndrome due to bilateral COVID-19 pneumonia on invasive mechanical ventilation (IMV) and analyze the effect of prolonged prone decubitus > 24 h (PPD) compared to prone decubitus < 24 h (PD).
Retrospective observational descriptive study. Uni and bivariate analysis.
Department of Intensive Care Medicine. General University Hospital of Elche.
Patients with SARS-CoV-2 pneumonia (2020-2021) in VMI for moderate-severe acute respiratory distress syndrome, ventilated in PD.
IMV. PD maneuvers.
Sociodemographic; analgo-sedation; neuromuscular blockade; PD (duration), ICU stay and mortality, days of IMV; non-infectious complications; health care-associated infections.
Fifty-one patients required PD and of these 31 (69.78%) required PPD. No differences were found in patient characteristics (sex, age, comorbidities, initial severity, antiviral and anti-inflammatory treatment received). Patients on PPD had lower tolerance to supine ventilation (61.29 vs. 89.47%, = 0.031), longer hospital stay (41 vs. 30 days, = 0.023), more days of IMV (32 vs. 20 days, = 0.032), longer duration of neuromuscular blockade (10.5 vs. 3 days, = 0.0002), as well as a higher percentage of episodes of orotracheal tube obstruction (48.39 vs. 15%, = 0.014).
PPD was associated with higher resource use and complications in patients with moderate-severe acute respiratory distress syndrome by COVID-19.
描述因双侧新型冠状病毒肺炎导致急性呼吸窘迫综合征并接受有创机械通气（IMV）的患者特征，并分析与俯卧位通气时间＜24小时（PD）相比，长时间俯卧位通气＞24小时（PPD）的效果。
回顾性观察描述性研究。单变量和双变量分析。
重症医学科。埃尔切综合大学医院。
2020 - 2021年因中度至重度急性呼吸窘迫综合征在有创机械通气下治疗的新型冠状病毒肺炎患者，接受俯卧位通气。
IMV。俯卧位通气操作。
社会人口统计学特征；镇痛镇静；神经肌肉阻滞；俯卧位通气（持续时间）、重症监护病房住院时间和死亡率、有创机械通气天数；非感染性并发症；医疗保健相关感染。
51例患者需要俯卧位通气，其中31例（69.78%）需要长时间俯卧位通气。患者特征（性别、年龄、合并症、初始严重程度、接受的抗病毒和抗炎治疗）未发现差异。长时间俯卧位通气的患者对仰卧位通气的耐受性较低（61.29%对89.47%，P = 0.031），住院时间更长（41天对30天，P = 0.023），有创机械通气天数更多（32天对20天，P = 0.032），神经肌肉阻滞持续时间更长（10.5天对3天，P = 0.0002），以及气管插管梗阻发作的百分比更高（48.39%对15%，P = 0.014）。
长时间俯卧位通气与新型冠状病毒肺炎所致中度至重度急性呼吸窘迫综合征患者更高的资源使用和并发症相关。
