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持续气道正压通气(CPAP)和双水平气道正压通气(BiPAP)对新冠病毒肺炎患者血流动力学参数影响的比较:一项临床试验

Comparison of the effect of Continuous Positive Airway Pressure (CPAP) and Bi-Level Positive Airway Pressure (BiPAP) on hemodynamic parameters in Covid-19 patients: A clinical trial.

作者信息

Nikbin Razieh, Beydokhti Tahereh Baloochi, Moghaddam Kokab Basiri, Rohandeh Zohreh

机构信息

School of Nursing, Gonabad University of Medical Sciences, Gonabad, Iran.

Department of Medical Emergencies, School of Nursing, Nursing Research Center, Gonabad University of Medical Sciences, Gonabad, Iran.

出版信息

J Educ Health Promot. 2023 May 31;12:178. doi: 10.4103/jehp.jehp_36_23. eCollection 2023.

Abstract

BACKGROUND

The most prevalent clinical sign for COVID-19 patients are respiratory diseases such that the criteria for clinical screening and care of the patients in most countries, including Iran, are based on the three primary symptoms, i.e., fever, cough, shortness of breath, or difficulty breathing. The purpose of the current study was to compare the effect of continuous positive airway pressure and bi-level positive airway pressure on hemodynamic parameters in COVID-19 patients.

MATERIALS AND METHODS

It was a clinical trial conducted on 46 COVID-19 patients admitted to Imam Hassan Hospital in Bojnourd in 2022. This study included patients selected through convenient sampling and then through Permuted block randomization, who were assigned to continuous positive airway pressure (CPAP), and Bi-Level Positive Airway Pressure (BiPAP) groups. Patients were compared in terms of the severity of their COVID-19 disease in both groups and were divided equally in each disease severity. After determining their type of respiratory aid use, the patient's hemodynamic status (systolic blood pressure, diastolic blood pressure, pulse, arterial oxygen saturation, and temperature) was examined beforehand, immediately after 1 hour, 6 hours, and then daily up to 3 days of CPAP/BiPAP at a specific time. Data collection tools were demographic data questionnaires and information on patients' diseases. A checklist was also used to record the main variables of the research. The collected data were put into SPSS software version 19. To analyze the data, the Kolmogorov-Smirnov normality test was used to evaluate the normality of quantitative variables. As a result, it was found that the data had a normal distribution. Repeated measures of ANOVA and independent t-tests were employed to compare quantitative variables in the two groups at different times. In this study, a significance level of 0.05 was considered.

RESULTS

There was a significant difference in terms of systolic blood pressure, diastolic blood pressure, respiration rate, pulse rate, oxygen saturation, and temperature in the two groups of patients at 1 day, 2 days, and 3 days after use ( < 0.05).

CONCLUSION

The results displayed better performance of CPAP than BiPAP in the parameters of systolic blood pressure, diastolic blood pressure, respiration rate, pulse rate, oxygen saturation, and temperature in COVID-19 patients. Therefore, in necessary cases, it is recommended to use a CPAP mask.

摘要

背景

新型冠状病毒肺炎(COVID-19)患者最常见的临床症状是呼吸系统疾病,因此包括伊朗在内的大多数国家,对患者进行临床筛查和护理的标准都基于三个主要症状,即发热、咳嗽、呼吸急促或呼吸困难。本研究的目的是比较持续气道正压通气(CPAP)和双水平气道正压通气(BiPAP)对COVID-19患者血流动力学参数的影响。

材料与方法

这是一项于2022年在博季努尔的伊玛目·哈桑医院对46例COVID-19患者进行的临床试验。本研究纳入的患者首先通过方便抽样选取,然后通过置换区组随机化分组,分为持续气道正压通气(CPAP)组和双水平气道正压通气(BiPAP)组。对两组患者的COVID-19疾病严重程度进行比较,并在每种疾病严重程度中平均分配。在确定患者使用的呼吸辅助类型后,在使用CPAP/BiPAP之前、使用后1小时、6小时以及之后每天特定时间直至3天,对患者的血流动力学状态(收缩压、舒张压、脉搏、动脉血氧饱和度和体温)进行检查。数据收集工具包括人口统计学数据问卷和患者疾病信息。还使用了一份清单来记录研究的主要变量。收集到的数据录入SPSS 19版软件。为分析数据,采用Kolmogorov-Smirnov正态性检验评估定量变量的正态性。结果发现数据呈正态分布。采用重复测量方差分析和独立t检验比较两组在不同时间的定量变量。本研究中,显著性水平设定为0.05。

结果

两组患者在使用后1天、2天和3天的收缩压、舒张压、呼吸频率、脉搏率、血氧饱和度和体温方面存在显著差异(P<0.05)。

结论

结果显示,在COVID-19患者的收缩压、舒张压、呼吸频率、脉搏率、血氧饱和度和体温参数方面,CPAP的表现优于BiPAP。因此,在必要情况下,建议使用CPAP面罩。

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