[新型冠状病毒肺炎呼吸窘迫综合征中的线性功率与死亡率]
[Linear power and mortality in COVID-19 respiratory difficulty syndrome].
作者信息
Lizama-Aguilar Alejandro, Bravo-Santibáñez Edgar, Ortega-Verdugo Karen Elena, Pacheco-Zavala Diego Ernesto, Moreno-Rivera José Luis
机构信息
Secretaría de Salud del Estado de Guanajuato, Hospital General de León, Unidad de Cuidados Intensivos. León, Guanajuato, México.
Secretaría de Salud del Estado de Guanajuato, Hospital General de León, Departamento de Enseñanza. León, Guanajuato, México.
出版信息
Rev Med Inst Mex Seguro Soc. 2024 Sep 2;62(5):1-6. doi: 10.5281/zenodo.12668053.
BACKGROUND
Acute respiratory distress syndrome (ARDS) secondary to COVID-19 crowded intensive care units in the world with high mortality. Mechanical ventilation was fundamental in the treatment; however, the evidence of ventilatory markers associated with mortality is not entirely clear. In 2021 it was described the linear power, which was superior to other markers. At the moment its possible utility in patients with ARDS due to COVID-19 has not been described.
OBJECTIVE
To evaluate linear power as a risk factor for mortality in patients with ARDS due to COVID-19 in intensive care.
MATERIAL AND METHODS
Retrospective cohort study in patients admitted to intensive care with ARDS secondary to COVID-19. Linear power was calculated for patients who died and patients who survived in intensive care. Mann-Whitney U test and multivariable Cox regression (hazard ratio [HR] with 95% confidence intervals [95% CI]) were performed.
RESULTS
60 patients were studied with a mortality of 43.3%. Those who died had a higher linear power (89.5 vs. 78, p = 0.031) and the best cut-off point was 84 cmH2O/rpm (AUC 0.663, p = 0.031, LR 2.02); in addition, those with linear power < 84 (p = 0.050) had a better cumulative survival.
CONCLUSIONS
Linear power is a possible risk factor for mortality in patients with ARDS secondary to COVID-19 in intensive care.
背景
新型冠状病毒肺炎（COVID-19）继发的急性呼吸窘迫综合征（ARDS）使全球重症监护病房人满为患，死亡率很高。机械通气是治疗的基础；然而，与死亡率相关的通气指标证据并不完全清楚。2021年有人描述了线性功率，它优于其他指标。目前，尚未描述其在COVID-19所致ARDS患者中的潜在效用。
目的
评估线性功率作为重症监护中COVID-19所致ARDS患者死亡风险因素的情况。
材料与方法
对因COVID-19继发ARDS而入住重症监护病房的患者进行回顾性队列研究。计算重症监护病房中死亡患者和存活患者的线性功率。进行曼-惠特尼U检验和多变量Cox回归（风险比[HR]及95%置信区间[95%CI]）。
结果
研究了60例患者，死亡率为43.3%。死亡患者的线性功率更高（89.5对78，p = 0.031），最佳截断点为84 cmH2O/转每分钟（AUC 0.663，p = 0.031，似然比2.02）；此外，线性功率<84的患者（p = 0.050）累积生存率更高。
结论
线性功率可能是重症监护中COVID-19继发ARDS患者死亡的风险因素。
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