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重症监护病房出院3个月后周围神经损伤的发生率及危险因素:一项比较新冠病毒感染和非新冠病毒感染重症幸存者的回顾性研究

Incidence and risk factors of peripheral nerve injuries 3 months after ICU discharge: a retrospective study comparing COVID-19 and non-COVID-19 critically ill survivors.

作者信息

Malengreaux C, Minguet P, Colson C, Dardenne N, Misset B, Rousseau A F

机构信息

Department of Intensive Care and Burn Centre, University Hospital of Liège, Avenue de L'Hôpital,1, University of Liège, Sart-Tilman B35, Liège, B-4000, Belgium.

University and Hospital Biostatistics Centre (B-STAT), University of Liège, Liège, Belgium.

出版信息

J Anesth Analg Crit Care. 2024 Feb 9;4(1):10. doi: 10.1186/s44158-024-00144-8.

Abstract

BACKGROUND

Peripheral nerve injuries (PNI) have been associated with prone positioning (PP) in mechanically ventilated (MV) patients with COVID-19 pneumonia. The aims of this retrospective study were to describe PNI prevalence 3 months (M3) after intensive care unit (ICU) discharge, whether patients survived COVID-19 or another critical illness, and to search for risk factors of PNI.

RESULTS

A total of 55 COVID (62 [54-69] years) and 22 non-COVID (61.5 [48-71.5] years) patients were followed at M3, after an ICU stay of respectively 15 [9-26.5] and 13.5 [10-19.8] days. PNI symptoms were reported by 23/55 (42.6%) COVID-19 and 8/22 (36%) non-COVID-19 patients (p = 0.798). As the incidence of PNI was similar in both groups, the entire population was used to determine risk factors. The MV duration predicted PNI occurrence (OR (CI95%) = 1.05 (1.01-1.10), p = 0.028), but not the ICU length of stay, glucocorticoids, or inflammation biomarkers.

CONCLUSION

In the present cohort, PNI symptoms were reported in at least one-third of the ICU survivors, in similar proportion whether patients suffered from severe COVID-19 or not.

摘要

背景

在新冠肺炎机械通气(MV)患者中,周围神经损伤(PNI)与俯卧位(PP)有关。这项回顾性研究的目的是描述重症监护病房(ICU)出院3个月(M3)后PNI的患病率、患者是否从新冠肺炎或其他危重症中存活下来,并寻找PNI的危险因素。

结果

共有55例新冠肺炎患者(62[54 - 69]岁)和22例非新冠肺炎患者(61.5[48 - 71.5]岁)在M3时接受随访,ICU住院时间分别为15[9 - 26.5]天和13.5[10 - 19.8]天。23/55(42.6%)的新冠肺炎患者和8/22(36%)的非新冠肺炎患者报告了PNI症状(p = 0.798)。由于两组PNI的发生率相似,因此使用整个人口来确定危险因素。机械通气时间可预测PNI的发生(OR(CI95%)= 1.05(1.01 - 1.10),p = 0.028),但ICU住院时间、糖皮质激素或炎症生物标志物则不能。

结论

在本队列中,至少三分之一的ICU幸存者报告了PNI症状,无论患者是否患有严重新冠肺炎,比例相似。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1499/10858596/499594192677/44158_2024_144_Fig1_HTML.jpg

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