Comparative Study of Hematological Parameters of Covid Positive Patients In ICU Requiring Oxygen With or Without Ventilatory Support

IF 0.1 Q4 ANESTHESIOLOGY Sri Lankan Journal of Anaesthesiology Pub Date : 2022-10-05 DOI:10.4038/slja.v30i2.8830
Sushmitha Salian, R. J. D’Cunha, Shannon F Fernandes, T. Gurumurthy
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Abstract

Background and aims:The ongoing Covid pandemic has burdened the medical system, more so due to the limited availability of ventilators. Our study aims at identifying the role of hematological markers in the risk stratification and the need for ventilator support among ICU admitted COVID-19 patients. Method(s): A single centre prospective study was conducted on 100 Covid positive patients admitted in the ICU to determine association between the haematological markers such as Hb, Platelet count, Total and Differential leukocyte count, CRP, AST, ALT, LDH, Ferritin and D-Dimer with the need for oxygen therapy with or without invasive ventilatory support. Comparative analysis was performed between the 2 groups. Result(s): Neutrophilia, a mean of 76.7% among those ventilated and 71.6% among those non ventilated (p value 0.002;highly significant) and Lymphocytopenia (p value 0.004) with a mean of 14% and 18.6% respectively was noted. Hemoglobin levels were lower in ventilated (mean 11.6g/dl) as against those non ventilated (mean 12.58%) p value 0.046 which was significant. D-dimer was increased in COVID-19 patients;mean 5380 ng/ml in ventilated patients and mean 949ng/ml in those non ventilated (P < 0.001 highly significant). Elevated D-dimer and presence of diabetes correlated with increased chances of mechanical ventilation, while higher hemoglobin levels and associated COPD have a negative association with the need of mechanical ventilation. Conclusion(s): Hypercoagulability along with neutrophilia and lymphocytopenia can be used as positive associations for the need for invasive mechanical ventilation. Copyright © 2022, College of Anaesthesiologists of Sri Lanka. All rights reserved.
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重症监护病房新冠肺炎阳性患者有与无呼吸支持输氧血液学参数的比较研究
背景和目标:持续的新冠肺炎疫情给医疗系统带来了负担,尤其是由于呼吸机的可用性有限。我们的研究旨在确定血液学标志物在风险分层中的作用,以及ICU收治的新冠肺炎患者对呼吸机支持的需求。方法:对100名入住ICU的新冠肺炎阳性患者进行了一项单中心前瞻性研究,以确定血红蛋白、血小板计数、白细胞总数和差异计数、CRP、AST、ALT、LDH、铁蛋白和D-二聚体等血液学标志物与是否需要有创通气支持的氧气治疗之间的关系。在两组之间进行比较分析。结果:中性粒细胞增多症在通气组中平均为76.7%,在非通气组中为71.6%(p值0.002;高度显著),淋巴细胞减少症(p值0.004)分别平均为14%和18.6%。通气组的血红蛋白水平(平均11.6g/dl)低于非通气组(平均12.58%),p值为0.046,这是显著的。新冠肺炎患者D-二聚体增加;通气组平均5380ng/ml,非通气组平均949ng/ml(P<0.001)。D-二聚体升高和糖尿病的存在与机械通气机会增加相关,而血红蛋白水平升高和相关的COPD与机械通气的需要呈负相关。结论:高凝性、中性粒细胞减少和淋巴细胞减少可作为有创机械通气需求的正相关因素。版权所有©2022,斯里兰卡麻醉师学院。保留所有权利。
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