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体外血液吸附对重症监护病房 COVID-19 危重症患者死亡率的影响。

Impact of extracorporeal hemadsorption on mortality in critically ill COVID-19 patients in the intensive care unit.

机构信息

Department of Internal Medicine Intensive Care Unit, Akdeniz University Faculty of Medicine, Antalya, Turkey.

Department of Internal Medicine Intensive Care Unit, Antalya Training and Research Hospital, Antalya, Turkey.

出版信息

Int J Artif Organs. 2024 Oct;47(10):736-742. doi: 10.1177/03913988241269527. Epub 2024 Sep 13.

Abstract

BACKGROUND

The consequences of COVID-19, such as respiratory failure and mortality, require the search for fast and effective solutions. The aim of this retrospective study is to determine the effect of extracorporeal hemadsorption on mortality in severe COVID-19 cases hospitalized in the intensive care unit (ICU).

METHODS

Our study is retrospective, single-center, and observational. The study included ICU patients diagnosed with COVID-19 who received extracorporeal hemadsorption treatment between March 2020 and December 2020. Effects on mortality were examined by comparing pre- and post-hemadsorption values.

RESULTS

Seventeen patients were included in the study. The mortality rate in the study was 64.7%. After hemadsorption, an increase was observed in the lymphocyte numbers, APACHE-II, and SOFA values of the patients ( = 0.026, 0.043, and 0.033; respectively). A significant decrease was observed in CRP and fibrinogen levels ( = 0.003 and 0.005; respectively). In the non-surviving patient group, APACHE-II, SOFA, and procalcitonin values were found to be high before and after the procedure ( = 0.002, 0.048, and 0.06; respectively).

CONCLUSION

In COVID-19 patients, APACHE-II and SOFA scores may be useful in predicting the effectiveness of extracorporeal hemadsorption. Our study found that patients with higher APACHE-II and SOFA scores at baseline had a higher mortality rate after hemadsorption. These findings show that the use of intensive care scoring systems may be useful in determining which patients should receive extracorporeal hemadsorption and that hemadsorption should be performed in the early stages of the disease.

摘要

背景

COVID-19 的后果,如呼吸衰竭和死亡率,需要寻找快速有效的解决方案。本回顾性研究的目的是确定体外血液吸附对重症 COVID-19 患者在重症监护病房(ICU)住院的死亡率的影响。

方法

我们的研究是回顾性的、单中心的和观察性的。该研究包括在 2020 年 3 月至 2020 年 12 月期间接受体外血液吸附治疗的被诊断患有 COVID-19 的 ICU 患者。通过比较血液吸附前后的值来检查对死亡率的影响。

结果

17 名患者被纳入研究。研究中的死亡率为 64.7%。血液吸附后,患者的淋巴细胞数、APACHE-II 和 SOFA 值增加(=0.026、0.043 和 0.033;分别)。CRP 和纤维蛋白原水平显著下降(=0.003 和 0.005;分别)。在非存活患者组中,APACHE-II、SOFA 和降钙素原值在治疗前后均较高(=0.002、0.048 和 0.06;分别)。

结论

在 COVID-19 患者中,APACHE-II 和 SOFA 评分可能有助于预测体外血液吸附的效果。我们的研究发现,基线时 APACHE-II 和 SOFA 评分较高的患者在血液吸附后死亡率较高。这些发现表明,使用重症监护评分系统可能有助于确定哪些患者应接受体外血液吸附,并且应在疾病早期进行血液吸附。

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