Baidu
map

Crit Care:基于肺形态的急性呼吸窘迫综合征患者一年结局

2022-06-04 MedSci原创 MedSci原创

肺形态反映了ARDS的急性期及其短期影响,但不反映长期结局,并且这只受合并症的影响。

急性呼吸窘迫综合征(ARDS)的死亡率自20世纪90年代末以来一直居高不下,没有下降的趋势。多种治疗方法未能提高急性呼吸窘迫综合征幸存者的生存率,其生活质量受到严重影响。急性呼吸窘迫综合征具有不同的表型和不同的短期预后。非局灶性ARDS患者的短期死亡率高于局灶性ARDS患者。近日,危重病医学领域权威杂志Critical Care上发表了一篇研究文章,该研究的目的是评估ARDS形态学表型对患者长期预后的影响。

这项目是对LIVE研究进行的二次分析,该研究是一项前瞻性随机对照试验,根据中度至重度ARDS患者的肺形态来评估个性化呼吸机设置的有效性。ARDS分为局灶性(仅肺后下部的实变)和非局灶性病变。研究人员在1年的随访中使用死亡率和生活质量功能评分来评估患者结局。

该研究共纳入了124例局灶性ARDS患者和236例非局灶性ARDS患者。非局灶性ARDS患者的1年死亡率高于局灶性ARDS患者(37% vs 24%,p=0.012)。非局灶性ARDS(风险比为3.44;95%置信区间为1.80-6.59;p<0.001)、年龄、McCabe评分、血液系统癌症、SAPSII评分和肾替代治疗与1年死亡率独立相关。

这种差异是由前90天的死亡率造成的(28 vs. 16%,p=0.010),但在90天到1年之间则不然(7 vs. 6%,p=0.591);此时,只有McCabe评分与死亡率独立相关。形态表型对患者报告的结局没有影响。

由此可见,肺形态反映了ARDS的急性期及其短期影响,但不反映长期结局,并且这只受合并症的影响。

原始出处:

Florian Blanchard,et al.One-year patient outcomes based on lung morphology in acute respiratory distress syndrome: secondary analysis of LIVE trial.Critical Care.2022.https://ccforum.biomedcentral.com/articles/10.1186/s13054-022-04036-7#Sec7

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=2033622, encodeId=92fe20336227a, content=<a href='/topic/show?id=5658193314f' target=_blank style='color:#2F92EE;'>#一年结局#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19331, encryptionId=5658193314f, topicName=一年结局)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Tue Apr 25 14:35:04 CST 2023, time=2023-04-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1227281, encodeId=393d122e281fd, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=28ca8165076, createdName=ms9000000011883750, createdTime=Sat Jun 18 22:34:37 CST 2022, time=2022-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1432327, encodeId=5917143232ebb, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Mon Jun 06 07:35:04 CST 2022, time=2022-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1582297, encodeId=4c38158229e5e, content=<a href='/topic/show?id=e46f396832b' target=_blank style='color:#2F92EE;'>#呼吸窘迫#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39683, encryptionId=e46f396832b, topicName=呼吸窘迫)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=22be16898890, createdName=12498cf9m40(暂无昵称), createdTime=Mon Jun 06 07:35:04 CST 2022, time=2022-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1224486, encodeId=0a421224486dc, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Sat Jun 04 23:05:47 CST 2022, time=2022-06-04, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=2033622, encodeId=92fe20336227a, content=<a href='/topic/show?id=5658193314f' target=_blank style='color:#2F92EE;'>#一年结局#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19331, encryptionId=5658193314f, topicName=一年结局)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Tue Apr 25 14:35:04 CST 2023, time=2023-04-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1227281, encodeId=393d122e281fd, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=28ca8165076, createdName=ms9000000011883750, createdTime=Sat Jun 18 22:34:37 CST 2022, time=2022-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1432327, encodeId=5917143232ebb, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Mon Jun 06 07:35:04 CST 2022, time=2022-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1582297, encodeId=4c38158229e5e, content=<a href='/topic/show?id=e46f396832b' target=_blank style='color:#2F92EE;'>#呼吸窘迫#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39683, encryptionId=e46f396832b, topicName=呼吸窘迫)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=22be16898890, createdName=12498cf9m40(暂无昵称), createdTime=Mon Jun 06 07:35:04 CST 2022, time=2022-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1224486, encodeId=0a421224486dc, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Sat Jun 04 23:05:47 CST 2022, time=2022-06-04, status=1, ipAttribution=)]
    2022-06-18 ms9000000011883750

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=2033622, encodeId=92fe20336227a, content=<a href='/topic/show?id=5658193314f' target=_blank style='color:#2F92EE;'>#一年结局#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19331, encryptionId=5658193314f, topicName=一年结局)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Tue Apr 25 14:35:04 CST 2023, time=2023-04-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1227281, encodeId=393d122e281fd, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=28ca8165076, createdName=ms9000000011883750, createdTime=Sat Jun 18 22:34:37 CST 2022, time=2022-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1432327, encodeId=5917143232ebb, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Mon Jun 06 07:35:04 CST 2022, time=2022-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1582297, encodeId=4c38158229e5e, content=<a href='/topic/show?id=e46f396832b' target=_blank style='color:#2F92EE;'>#呼吸窘迫#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39683, encryptionId=e46f396832b, topicName=呼吸窘迫)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=22be16898890, createdName=12498cf9m40(暂无昵称), createdTime=Mon Jun 06 07:35:04 CST 2022, time=2022-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1224486, encodeId=0a421224486dc, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Sat Jun 04 23:05:47 CST 2022, time=2022-06-04, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=2033622, encodeId=92fe20336227a, content=<a href='/topic/show?id=5658193314f' target=_blank style='color:#2F92EE;'>#一年结局#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19331, encryptionId=5658193314f, topicName=一年结局)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Tue Apr 25 14:35:04 CST 2023, time=2023-04-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1227281, encodeId=393d122e281fd, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=28ca8165076, createdName=ms9000000011883750, createdTime=Sat Jun 18 22:34:37 CST 2022, time=2022-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1432327, encodeId=5917143232ebb, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Mon Jun 06 07:35:04 CST 2022, time=2022-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1582297, encodeId=4c38158229e5e, content=<a href='/topic/show?id=e46f396832b' target=_blank style='color:#2F92EE;'>#呼吸窘迫#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39683, encryptionId=e46f396832b, topicName=呼吸窘迫)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=22be16898890, createdName=12498cf9m40(暂无昵称), createdTime=Mon Jun 06 07:35:04 CST 2022, time=2022-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1224486, encodeId=0a421224486dc, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Sat Jun 04 23:05:47 CST 2022, time=2022-06-04, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=2033622, encodeId=92fe20336227a, content=<a href='/topic/show?id=5658193314f' target=_blank style='color:#2F92EE;'>#一年结局#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19331, encryptionId=5658193314f, topicName=一年结局)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Tue Apr 25 14:35:04 CST 2023, time=2023-04-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1227281, encodeId=393d122e281fd, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=28ca8165076, createdName=ms9000000011883750, createdTime=Sat Jun 18 22:34:37 CST 2022, time=2022-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1432327, encodeId=5917143232ebb, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Mon Jun 06 07:35:04 CST 2022, time=2022-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1582297, encodeId=4c38158229e5e, content=<a href='/topic/show?id=e46f396832b' target=_blank style='color:#2F92EE;'>#呼吸窘迫#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39683, encryptionId=e46f396832b, topicName=呼吸窘迫)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=22be16898890, createdName=12498cf9m40(暂无昵称), createdTime=Mon Jun 06 07:35:04 CST 2022, time=2022-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1224486, encodeId=0a421224486dc, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Sat Jun 04 23:05:47 CST 2022, time=2022-06-04, status=1, ipAttribution=)]
    2022-06-04 1209e435m98(暂无昵称)

    学习了,谢谢分享

    0

相关资讯

Journal of Tissue Viability:俯卧位通气患者皮肤损伤该如何预防?

目前,专门设计用于俯卧位通气避免皮肤损伤的设备/装置较少。

表面活性剂治疗晚期早产儿和足月新生儿呼吸窘迫综合征

在过去的几十年里,呼吸窘迫综合征 (RDS) 的管理有了很大的发展,外源性表面活性剂替代品是其特殊的基石之一。

NEJM:脂肪栓塞综合征的少见病因

26岁,女性。 腹壁成形术和抽脂术3天后出现呼吸衰竭和精神状态改变。

Crit Care:体外膜肺氧合治疗COVID-19和H1N1流感相关急性呼吸窘迫综合征效果比较

在接受体外膜肺氧合的ARDS患者中,研究人员观察到未经调整的60天死亡率在COVID-19患者中高于H1N1肺炎患者。多变量调整后,死亡率的差异不显著。

Chest:阿司匹林治疗急性呼吸窘迫综合征的疗效分析

阿司匹林的耐受性良好,但并没有改善受试者OI或其他生理结局,在当前实验设计中开展更大型的试验是不可行的。

Crit Care:急性呼吸窘迫综合征(ARDS)的COVID-19患者早期短疗程神经肌肉阻断剂的治疗效果

对于中重度急性呼吸窘迫综合征(ARDS)的COVID-19患者,早期开始NMBA短程治疗并没有显著改善患者90天死亡率和VFD。在缺乏来自临床试验的明确数据的情况下,这类患者应谨慎使用NMBA。

Baidu
map
Baidu
map
Baidu
map