Mehri Zahra, Mehr Azam Jahangiri, Molavynejad Shahram, Navarbafzadeh Najmeh, Adineh Mohammad, Nazari Mohammad, Nematollahzadeh Zohreh
Scientometrics Shoushtar Faculty of Medical Sciences, Shoushtar, Iran.
Biostatistics, Shoushtar Faculty of Medical Sciences, Shoushtar, Iran.
Iran J Nurs Midwifery Res. 2024 Nov 20;29(6):697-702. doi: 10.4103/ijnmr.ijnmr_392_22. eCollection 2024 Nov-Dec.
Considering the importance of using Non-Invasive Ventilation (NIV) in COVID-19-related hypoxemia, the present study was conducted to determine the effective factors on Continuous Positive Airway Pressure (CPAP) failure rate in COVID-19-related hypoxemia.
This research was a retrospective cross-sectional study (2021) investigating the records of 200 adult patients with the medical diagnosis of acute respiratory failure (ARF) of COVID-19, admitted to the Intensive Care Unit (ICU) in Shoushtar (southwestern Iran) who underwent CPAP therapy. The Heart rate, Acidosis, Consciousness, Oxygenation, and Respiratory rate (HACOR) scores were measured before the treatment and 1 h after undergoing CPAP treatment. Moreover, patients' demographic and clinical data were recorded. Data were analyzed using the Mann-Whitney, Chi-square, Wilcoxon, and logistic regression tests. The significance level was set at ≤ 0.05.
The mean standard deviation [SD]) age of patients was 63.96 (16.23) years. Among all 200 patients, 78.50% ( = 157) experienced CPAP failure and the remaining 21.50% ( = 43) underwent successful CPAP therapy. Failure chance was 7.10% higher in patients with higher HACOR scores undergoing 1 h CPAP treatment than others. It was also 14.92% higher among patients with diabetes mellitus (DM) than non-DM patients. Additionally, old age (z = 2591.50, value = 0.02), obesity (z = 2433.00, value = 0.024), and elevated Blood Urea Nitrogen (BUN) (z = 2620.00, value = 0.0) impacted CPAP failure rates among patients.
The HACOR score 1 h after CPAP, DM, old age, obesity, and elevated BUN favor increased CPAP failure rates among patients.
考虑到无创通气（NIV）在新型冠状病毒肺炎（COVID-19）相关低氧血症治疗中的重要性，本研究旨在确定影响COVID-19相关低氧血症患者持续气道正压通气（CPAP）失败率的相关因素。
本研究为回顾性横断面研究（2021年），调查了200例医学诊断为COVID-19急性呼吸衰竭（ARF）的成年患者的记录，这些患者入住伊朗西南部舒什塔尔的重症监护病房（ICU）并接受了CPAP治疗。在治疗前和接受CPAP治疗1小时后测量心率、酸中毒、意识、氧合和呼吸频率（HACOR）评分。此外，记录患者的人口统计学和临床数据。使用曼-惠特尼检验、卡方检验、威尔科克森检验和逻辑回归检验对数据进行分析。显著性水平设定为≤0.05。
患者的平均年龄为63.96（16.23）岁。在所有200例患者中，78.50%（n = 157）经历了CPAP失败，其余21.50%（n = 43）接受了成功的CPAP治疗。接受1小时CPAP治疗的HACOR评分较高的患者失败几率比其他患者高7.10%。糖尿病（DM）患者的失败几率也比非DM患者高14.92%。此外，老年（z = 2591.50，p值 = 0.02）、肥胖（z = 2433.00，p值 = 0.024）和血尿素氮（BUN）升高（z = 2620.00，p值 = 0.0）影响患者的CPAP失败率。
CPAP治疗1小时后的HACOR评分、DM、老年、肥胖和BUN升高会增加患者的CPAP失败率。
