重症监护室出院 3 个月后周围神经损伤的发生率和风险因素:一项比较 COVID-19 和非 COVID-19 重症幸存者的回顾性研究。

C Malengreaux, P Minguet, C Colson, N Dardenne, B Misset, A F Rousseau
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引用次数: 0

摘要

背景:COVID-19肺炎机械通气(MV)患者的俯卧位(PP)与周围神经损伤(PNI)有关。这项回顾性研究的目的是描述重症监护病房(ICU)出院后 3 个月(M3)内 PNI 的发生率、患者是否在 COVID-19 或其他危重疾病中存活,并寻找 PNI 的风险因素:共有 55 名 COVID 患者(62 [54-69] 岁)和 22 名非 COVID 患者(61.5 [48-71.5] 岁)在重症监护室分别住院 15 [9-26.5] 天和 13.5 [10-19.8] 天后接受了 M3 随访。23/55(42.6%)名 COVID-19 患者和 8/22(36%)名非 COVID-19 患者报告了 PNI 症状(P = 0.798)。由于两组患者的 PNI 发生率相似,因此采用整个人群来确定风险因素。MV持续时间可预测PNI的发生(OR (CI95%) = 1.05 (1.01-1.10),p = 0.028),但ICU住院时间、糖皮质激素或炎症生物标志物不能预测PNI的发生:在本研究队列中,至少有三分之一的 ICU 存活者出现了 PNI 症状,无论患者是否患有严重的 COVID-19,其比例都相似。
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Incidence and risk factors of peripheral nerve injuries 3 months after ICU discharge: a retrospective study comparing COVID-19 and non-COVID-19 critically ill survivors.

Background: Peripheral nerve injuries (PNI) have been associated with prone positioning (PP) in mechanically ventilated (MV) patients with COVID-19 pneumonia. The aims of this retrospective study were to describe PNI prevalence 3 months (M3) after intensive care unit (ICU) discharge, whether patients survived COVID-19 or another critical illness, and to search for risk factors of PNI.

Results: A total of 55 COVID (62 [54-69] years) and 22 non-COVID (61.5 [48-71.5] years) patients were followed at M3, after an ICU stay of respectively 15 [9-26.5] and 13.5 [10-19.8] days. PNI symptoms were reported by 23/55 (42.6%) COVID-19 and 8/22 (36%) non-COVID-19 patients (p = 0.798). As the incidence of PNI was similar in both groups, the entire population was used to determine risk factors. The MV duration predicted PNI occurrence (OR (CI95%) = 1.05 (1.01-1.10), p = 0.028), but not the ICU length of stay, glucocorticoids, or inflammation biomarkers.

Conclusion: In the present cohort, PNI symptoms were reported in at least one-third of the ICU survivors, in similar proportion whether patients suffered from severe COVID-19 or not.

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