一份初步报告:COVID-19的快速临床演变导致早期住院和不利结果

IF 2.3 Multidisciplinary Respiratory Medicine Pub Date : 2021-04-02 eCollection Date: 2021-01-15 DOI:10.4081/mrm.2021.744
Markus Heim, Tobias Lahmer, Sebastian Rasch, Silja Kriescher, Wiebke Berg-Johnson, Kristina Fuest, Barbara Kapfer, Gerhard Schneider, Christoph D Spinner, Fabian Geisler, Johannes R Wießner, Kathrin Rothe, Susanne Feihl, Andreas Ranft
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摘要

背景:重症监护病房COVID-19患者的死亡率有很大差异。我们想描述临床过程,并确定我们机构重症监护病房的死亡率。方法:为此,我们对德国某大型大学附属医院ICU收治的50例COVID-19患者进行了回顾性队列研究。临床特征报告重点ICU干预,如机械通气,俯卧位和体外器官支持。在ICU入院后的第28天和第60天,采用7分的顺序量表给出结果。结果:中位年龄64岁,男性占78%。LDH和d -二聚体升高,患者维生素d含量低,ARDS发生率为75%,43/50患者需要有创通气。22/50的患者需要间歇性俯卧位,7/50的患者需要ECMO。从出现首次症状到住院和进入ICU的时间间隔,非幸存者比幸存者短。入院后第60天,52%的患者已出院。60天死亡率为32%;37%为通气患者,42%为同时需要通气和肾脏替代治疗的患者。结论:早期恶化可能被视为不利结果的警告信号。包括俯卧位在内的肺保护性通气仍然是主要的治疗方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Rapid clinical evolution for COVID-19 translates into early hospital admission and unfavourable outcome: a preliminary report.

Background: A wide range of mortality rates has been reported in COVID-19 patients on the intensive care unit. We wanted to describe the clinical course and determine the mortality rate in our institution's intensive care units.

Methods: To this end, we performed a retrospective cohort study of 50 COVID-19 patients admitted to the ICU at a large German tertiary university hospital. Clinical features are reported with a focus on ICU interventions, such as mechanical ventilation, prone positioning and extracorporeal organ support. Outcome is presented using a 7-point ordinal scale on day 28 and 60 following ICU admission.

Results: The median age was 64 years, 78% were male. LDH and D-Dimers were elevated, and patients were low on Vitamin D. ARDS incidence was 75%, and 43/50 patients needed invasive ventilation. 22/50 patients intermittently needed prone positioning, and 7/50 required ECMO. The interval from onset of the first symptoms to admission to the hospital and to the ICU was shorter in non-survivors than in survivors. By day 60 after ICU admission, 52% of the patients had been discharged. 60-day mortality rate was 32%; 37% for ventilated patients, and 42% for those requiring both: ventilation and renal replacement therapy.

Conclusions: Early deterioration might be seen as a warning signal for unfavourable outcome. Lung-protective ventilation including prone positioning remain the mainstay of the treatment.

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来源期刊
Multidisciplinary Respiratory Medicine
Multidisciplinary Respiratory Medicine Medicine-Pulmonary and Respiratory Medicine
自引率
0.00%
发文量
23
期刊介绍: Multidisciplinary Respiratory Medicine is the official journal of the Italian Respiratory Society - Società Italiana di Pneumologia (IRS/SIP). The journal publishes on all aspects of respiratory medicine and related fields, with a particular focus on interdisciplinary and translational research. The interdisciplinary nature of the journal provides a unique opportunity for researchers, clinicians and healthcare professionals across specialties to collaborate and exchange information. The journal provides a high visibility platform for the publication and dissemination of top quality original scientific articles, reviews and important position papers documenting clinical and experimental advances.
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