机械功率及其成分与年龄的相关性及其对压力控制通气受试者SARS-CoV-2预后的干扰

C. Franck, Gustavo Maysonnave Franck, Ehab Daoud
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引用次数: 1

摘要

引言严重急性呼吸系统综合征冠状病毒2型可能与ARDS和VILI有关。然而,潮汐能对结果的相关性和干扰仍然存在疑问。本研究的目的是验证接受压力控制通气(PCV)的受试者在严重急性呼吸系统综合征冠状病毒2型的结果中,机械力及其成分与年龄的相关性和干扰。方法对收集的机械呼吸机两个参数的信息进行纵向、前瞻性、观察性、分析性和定量研究,通过Becher公式计算2021年5月至2021年9月期间163名严重急性呼吸系统综合征冠状病毒2型和中度ARDS受试者的机械功率。结果除顺应性(P 0.234)、弹性(P 0.515)、阻力(P 0.570)和年龄(P 0.180)外,机械力及其组成部分之间存在相关性。在年龄的单变量分析中,除呼气末正压(PEEP)(P 0.874)、分钟通气(Ve)(P 0.437),阻力(PRresist)(P 0.410)和阻力(P 0.071)。机械功率、平台压力(PPlateau)、潮气量(VT)、驱动压力(ΔP)和弹性的多元分析,结果表明,只有机械力与死亡相关(P 0.04),每增加一个单位J/分钟,死亡几率增加6.2%(95%IC 0.3%;12.4%)。除PEEP、Ve、PR电阻和阻力外,年龄、机械功率及其成分的单变量分析结果存在干扰,但多变量分析表明,只有机械功率与接受PCV的严重急性呼吸系统综合征冠状病毒2型的结果相关。关键词:严重急性呼吸系统综合征冠状病毒2型感染;死亡率通气性肺损伤;急性呼吸窘迫综合征
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Correlations of mechanical power and its components with age and its interference in the outcome of SARS-CoV-2 in subjects undergoing pressure-controlled ventilation
Introduction SARS-CoV-2 may be associated with ARDS and the VILI. However, there are still doubts about the correlations and the interference of tidal energy in the outcomes. The objective of this study was to verify the correlations and interference of mechanical power and its components with age in the outcome in SARS-CoV-2 of subjects undergoing pressure-controlled ventilation (PCV). Method Longitudinal, prospective, observational, analytical, and quantitative study of the information collected on two parameters of the mechanical ventilator, to calculate the mechanical power by Becher formula in 163 subjects with SARS-CoV-2 and moderate ARDS between May 2021 to September 2021. Results Correlations were found between mechanical power and its components, except for compliance (P 0.234), elastance (P 0.515), resistance (P 0.570) and age (P 0.180). There was a significant impact on the outcome in the univariate analysis of age, as well as of mechanical power and its components, except for positive end expiratory pressure (PEEP) (P 0.874), minute ventilation (Ve) (P 0.437), resistive pressure (PResist) (P 0.410) and resistance (P 0.071). The multivariate analysis of mechanical power, plateau pressure (PPlateau), tidal volume (VT), driving pressure (ΔP) and elastance, showed that only mechanical power correlated to death (P 0.04) and for each additional unit in J/minute there is a 6.2% increase in the odds of death (95% IC 0.3%; 12.4%). Conclusion There are correlations between mechanical power and its components, except for compliance, elastance, resistance, and age. There is interference in the outcome in the univariate analysis of age, as well as of mechanical power and its components, except PEEP, Ve, PResist and resistance, but the multivariate analysis showed that only mechanical power correlates with the outcome in SARS-CoV-2 undergoing PCV. Keywords: SARS-CoV-2 infection; Mortality; Ventilation Induced Lung Injury; Acute Respiratory Distress Syndrome
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