دورية أكاديمية
أعرض في EDS

Impacts of a fraction of inspired oxygen adjustment protocol in COVID-19 patients under mechanical ventilation: A prospective cohort study.

التفاصيل البيبلوغرافية
العنوان: Impacts of a fraction of inspired oxygen adjustment protocol in COVID-19 patients under mechanical ventilation: A prospective cohort study.
المؤلفون: Gomes EP; Pulmonary and Critical Care Division, University Hospital of Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil.; School of Medicine, Federal University of Juiz de Fora, Juiz de Fora, Brazil., Reboredo MM; Pulmonary and Critical Care Division, University Hospital of Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil.; School of Medicine, Federal University of Juiz de Fora, Juiz de Fora, Brazil., Costa GB; Pulmonary and Critical Care Division, University Hospital of Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil., Barros FS; Pulmonary and Critical Care Division, University Hospital of Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil., Carvalho EV; Pulmonary and Critical Care Division, University Hospital of Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil.; School of Medicine, Federal University of Juiz de Fora, Juiz de Fora, Brazil., Pinheiro BV; Pulmonary and Critical Care Division, University Hospital of Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil.; School of Medicine, Federal University of Juiz de Fora, Juiz de Fora, Brazil.
المصدر: Medicina intensiva [Med Intensiva] 2023 Apr; Vol. 47 (4), pp. 212-220. Date of Electronic Publication: 2022 May 02.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Elsevier España Country of Publication: Spain NLM ID: 9207689 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1578-6749 (Electronic) Linking ISSN: 02105691 NLM ISO Abbreviation: Med Intensiva Subsets: PubMed not MEDLINE
أسماء مطبوعة: Publication: <2009-> : Madrid : Elsevier España
Original Publication: Madrid : IDEPSA, International de Ediciones y Publicaciones, S.A.,
مستخلص: Objective: We examined weather a protocol for fraction of inspired oxygen (FiO 2 ) adjustment can reduce hyperoxemia and excess oxygen use in COVID-19 patients mechanically ventilated.
Design: Prospective cohort study.
Setting: Two intensive care units (ICUs) dedicated to COVID-19 patients in Brazil.
Patients: Consecutive patients with COVID-19 mechanically ventilated.
Interventions: One ICU followed a FiO 2 adjustment protocol based on SpO 2 (conservative-oxygen ICU) and the other, which did not follow the protocol, constituted the control ICU.
Main Variables of Interest: Prevalence of hyperoxemia (PaO 2  >100 mmHg) on day 1, sustained hyperoxemia (present on days 1 and 2), and excess oxygen use (FiO 2  > 0.6 in patients with hyperoxemia) were compared between the two ICUs.
Results: Eighty two patients from the conservative-oxygen ICU and 145 from the control ICU were included. The conservative-oxygen ICU presented lower prevalence of hyperoxemia on day 1 (40.2% vs. 75.9%, p  < 0.001) and of sustained hyperoxemia (12.2% vs. 49.6%, p  < 0.001). Excess oxygen use was less frequent in the conservative-oxygen ICU on day 1 (18.3% vs. 52.4%, p  < 0.001). Being admitted in the control ICU was independently associated with hyperoxemia and excess oxygen use. Multivariable analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FiO 2 use and adverse clinical outcomes.
Conclusions: Following FiO 2 protocol was associated with lower hyperoxemia and less excess oxygen use. Although those results were not associated with better clinical outcomes, adopting FiO 2 protocol may be useful in a scenario of depleted oxygen resources, as was seen during the COVID-19 pandemic.
(© 2022 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.)
References: N Engl J Med. 2021 Apr 8;384(14):1301-1311. (PMID: 33471452)
Lancet. 2018 Apr 28;391(10131):1693-1705. (PMID: 29726345)
Crit Care Med. 2018 Apr;46(4):517-524. (PMID: 29261565)
Crit Care. 2020 Mar 31;24(1):125. (PMID: 32234077)
JAMA Netw Open. 2021 Jan 4;4(1):e2034266. (PMID: 33464319)
Lancet Respir Med. 2021 Sep;9(9):989-998. (PMID: 34224674)
Acta Anaesthesiol Scand. 2022 Jan;66(1):76-84. (PMID: 34425016)
Intensive Care Med. 2012 Jan;38(1):91-8. (PMID: 22127482)
Respir Care. 2013 Jan;58(1):123-41. (PMID: 23271823)
J Bras Pneumol. 2021 May 31;47(3):e20210104. (PMID: 34076177)
Eur Respir J. 2021 Oct 1;58(3):. (PMID: 33632796)
Ann Intensive Care. 2014 Jul 25;4:23. (PMID: 25512878)
Ann Intensive Care. 2015 Dec;5(1):42. (PMID: 26585328)
Br J Anaesth. 2020 Apr;124(4):420-429. (PMID: 32753102)
N Engl J Med. 2020 Mar 12;382(11):999-1008. (PMID: 32160661)
Lancet Respir Med. 2021 Feb;9(2):139-148. (PMID: 33169671)
Intensive Care Med. 2011 Jan;37(1):46-51. (PMID: 20878146)
فهرسة مساهمة: Keywords: COVID-19; Hyperoxia; Intensive care unit; Mechanical ventilation
Local Abstract: [Publisher, Spanish; Castilian] Evaluar si un protocolo para el ajuste de la FiO 2 reduce la hiperoxemia y el uso excesivo de oxígeno en pacientes con COVID-19 en ventilación mecánica. [Publisher, Spanish; Castilian] Estudio de cohorte prospectivo. [Publisher, Spanish; Castilian] Unidades de cuidados intensivos (UCI) dedicadas a pacientes con COVID-19 en Brasil. [Publisher, Spanish; Castilian] Pacientes con COVID-19. [Publisher, Spanish; Castilian] Una UCI siguió un protocolo de ajuste de FiO 2 basado en SpO 2 (UCI de oxigenoterapia conservadora, N = 82) y la otra no siguió el protocolo (UCI control, N = 145). [Publisher, Spanish; Castilian] Prevalencia de hiperoxemia (PaO 2  > 100 mmHg) en el día 1, hiperoxemia sostenida (presente en los días 1 y 2) y exceso de uso de oxígeno (FiO 2  > 0,6 en pacientes con hiperoxemia) entre las 2 UCI. [Publisher, Spanish; Castilian] La UCI de oxigenoterapia conservadora presentó menor prevalencia de hiperoxemia en el día 1 (40,2 vs. 75,9%; p < 0,001) y de hiperoxemia sostenida (12,2 vs. 49,6%; p < 0,001). El uso excesivo de oxígeno fue menos frecuente en la UCI de oxigenoterapia conservadora el día 1 (18,3 vs. 52,4%; p < 0,001). El ingreso en la UCI control se asoció de forma independiente con la hiperoxemia y el uso excesivo de oxígeno. Los análisis multivariables no encontraron una relación independiente entre hiperoxemia o uso excesivo de FiO 2 y resultados clínicos adversos. [Publisher, Spanish; Castilian] Seguir el protocolo de FiO 2 se asoció con menor hiperoxemia y menor consumo de oxígeno en exceso. Aunque esos resultados no se asociaron con mejores resultados clínicos, la adopción del protocolo FiO 2 puede ser útil en un escenario de recursos de oxígeno agotados, como se vio durante la pandemia de COVID-19.
تواريخ الأحداث: Date Created: 20220509 Latest Revision: 20230328
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC9058051
DOI: 10.1016/j.medin.2022.04.004
PMID: 35528275
قاعدة البيانات: MEDLINE
الوصف
تدمد:1578-6749
DOI:10.1016/j.medin.2022.04.004