静脉注射免疫球蛋白治疗新冠肺炎ARDS患者的心脏不良反应调查。

Northern clinics of Istanbul Pub Date : 2023-08-26 eCollection Date: 2023-01-01 DOI:10.14744/nci.2023.50336
Ayse Ayyildiz, Ozge Turgay Yildirim, Anil Ucan, Fatih Alper Ayyildiz, Fezan Mutlu
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摘要

目的:静脉注射免疫球蛋白(IVIG)治疗新冠肺炎感染后急性呼吸窘迫综合征(CARDS)日益流行。在本研究中,我们旨在回顾性评估接受IVIG治疗的CARDS患者可能的心脏影响。方法:记录接受IVIG处理的CARDS病人的人口学和临床特征、死亡率、心电图、超声心动图、心脏标志物和其他实验室参数。结果:患者平均年龄为68.7±13.6%,女性占70.5%。重症监护室的平均住院天数为18.2±9.7天,死亡率为35.2%。在连续的心电图随访中没有观察到病理节律或缺血性变化。然而,在连续的ECO随访中,治疗结束时的sPAP值在数值上较低,尽管没有统计学意义。结论:我们的研究表明,IVIG治疗可能安全地用于有心血管副作用的新冠肺炎患者。然而,由于这些患者凝血障碍的风险很高,应密切监测IVIG治疗新冠肺炎感染的使用情况,因为这可能会增加心血管风险。此外,监测心脏参数也很重要,因为它可以预测患者的高心血管风险。因此,患者需要较低的输注率、类固醇组合、充足的水合作用和有效的抗凝治疗来避免这些副作用。
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Investigation of cardiac adverse effects in COVID-19 ARDS patients treated with intravenous immunoglobulin.

Objective: The popularity of intravenous immunoglobulin (IVIG) therapy in Acute Respiratory Distress Syndrome (CARDS) secondary to COVID-19 infection is increasing day by day. In this study, we aimed to retrospectively evaluate the possible cardiac effects in our CARDS patients treated with IVIG.

Methods: Demographic and clinical characteristics, mortality, sequential electrocardiography (ECG), echocardiography, cardiac markers, and other laboratory parameters of CARDS patients who received IVIG treatment were recorded.

Results: The mean age of the patients was 68.7±13.6%, and 70.5% were female. The mean number of days of hospitalization in the intensive care unit was 18.2±9.7, and the mortality rate was recorded as 35.2%. No pathological rhythm or ischemic change was observed in sequential ECG follow-ups. However, in consecutive ECO follow-ups, the sPAP values at the treatment end were numerically lower, although not statistically significant.

Conclusion: Our study suggests that IVIG therapy may be used safely in COVID-19 patients with cardiovascular side effects. However, due to the high risk of coagulopathy in these patients, the use of IVIG therapy in COVID-19 infection should be monitored with close monitoring, as it may increase the potential for cardiovascular risk. Furthermore, monitoring cardiac parameters are also essential as it may predict high cardiovascular risk in patients. For this reason, patients need lower infusion rates, steroid combination, adequate hydration, and effective anticoagulation therapy to avoid these side effects.

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