PDF(Pubmed)
Abstract：
BACKGROUND: Pneumocystis pneumonia is an uncommon precipitant of acute respiratory distress syndrome and is associated with high mortality. Prone positioning ventilation has been proven to reduce mortality in patients with moderate-severe acute respiratory distress syndrome. We investigated the effect of prone positioning on oxygenation and mortality in intubated patients with pneumocystis pneumonia comorbid with moderate-severe acute respiratory distress syndrome.
METHODS: In this single-center, retrospective, observational, cohort study, eligible patients were enrolled at West China Hospital of Sichuan University from January 1, 2017, to December 31, 2021. Data on demographics, clinical features, ventilation parameters, arterial blood gas, and outcomes were collected. Patients were assigned to the prone cohort or supine cohort according to whether they received prone positioning ventilation. The main outcome was 28-day mortality.
RESULTS: A total of 79 patients were included in the study. Sixty-three patients were enrolled in the prone cohort, and 16 patients were enrolled in the supine cohort. The 28-day mortality was 61.9% in the prone cohort and 68.8% in the supine cohort (P = 0.26), and 90-day mortality was 66.7% in the prone cohort and 68.8% in the supine cohort (P = 0.55). Patients in the supine cohort had fewer invasive mechanical ventilation days and more ventilator-free days. The incidence of complications was higher in the prone cohort than in the supine cohort.
CONCLUSIONS: In patients with pneumocystis pneumonia and moderate-severe acute respiratory distress syndrome, prone positioning did not decrease 28-day or 90-day mortality. Trial registration ClinicalTrials.gov number, ChiCTR2200063889. Registered on 20 September 2022, https://www.chictr.org.cn/showproj.html?proj=174886 .
METHODS: In this single-center, retrospective, observational, cohort study, eligible patients were enrolled at West China Hospital of Sichuan University from January 1, 2017, to December 31, 2021. Data on demographics, clinical features, ventilation parameters, arterial blood gas, and outcomes were collected. Patients were assigned to the prone cohort or supine cohort according to whether they received prone positioning ventilation. The main outcome was 28-day mortality.
RESULTS: A total of 79 patients were included in the study. Sixty-three patients were enrolled in the prone cohort, and 16 patients were enrolled in the supine cohort. The 28-day mortality was 61.9% in the prone cohort and 68.8% in the supine cohort (P = 0.26), and 90-day mortality was 66.7% in the prone cohort and 68.8% in the supine cohort (P = 0.55). Patients in the supine cohort had fewer invasive mechanical ventilation days and more ventilator-free days. The incidence of complications was higher in the prone cohort than in the supine cohort.
CONCLUSIONS: In patients with pneumocystis pneumonia and moderate-severe acute respiratory distress syndrome, prone positioning did not decrease 28-day or 90-day mortality. Trial registration ClinicalTrials.gov number, ChiCTR2200063889. Registered on 20 September 2022, https://www.chictr.org.cn/showproj.html?proj=174886 .
摘要：
背景：肺孢子菌肺炎是一种罕见的急性呼吸窘迫综合征的诱发因素，并与高死亡率相关。俯卧位通气已被证明可降低中重度急性呼吸窘迫综合征患者的死亡率。我们研究了俯卧位对肺囊虫肺炎合并中重度急性呼吸窘迫综合征插管患者氧合和死亡率的影响。
方法：在这个单中心，回顾性,观察,队列研究,符合条件的患者于2017年1月1日至2021年12月31日在四川大学华西医院入选.人口统计数据，临床特征,通风参数,动脉血气,并收集结果。根据患者是否接受俯卧位通气，将患者分为俯卧组或仰卧组。主要结果是28天死亡率。
结果：共有79名患者被纳入研究。63例患者被纳入易感队列，16例患者纳入仰卧位队列。俯卧组28天死亡率为61.9%，仰卧组为68.8%(P=0.26)。俯卧组90日死亡率为66.7%,仰卧组为68.8%(P=0.55).仰卧组患者有创机械通气天数较少，无呼吸机天数较多。俯卧队列的并发症发生率高于仰卧位队列。
结论：在肺孢子菌肺炎和中重度急性呼吸窘迫综合征患者中，俯卧位没有降低28天或90天死亡率。试用注册ClinicalTrials.gov编号，ChiCTR2200063889。2022年9月20日注册，https://www。chictr.org.cn/showproj.html?proj=174886。
方法：在这个单中心，回顾性,观察,队列研究,符合条件的患者于2017年1月1日至2021年12月31日在四川大学华西医院入选.人口统计数据，临床特征,通风参数,动脉血气,并收集结果。根据患者是否接受俯卧位通气，将患者分为俯卧组或仰卧组。主要结果是28天死亡率。
结果：共有79名患者被纳入研究。63例患者被纳入易感队列，16例患者纳入仰卧位队列。俯卧组28天死亡率为61.9%，仰卧组为68.8%(P=0.26)。俯卧组90日死亡率为66.7%,仰卧组为68.8%(P=0.55).仰卧组患者有创机械通气天数较少，无呼吸机天数较多。俯卧队列的并发症发生率高于仰卧位队列。
结论：在肺孢子菌肺炎和中重度急性呼吸窘迫综合征患者中，俯卧位没有降低28天或90天死亡率。试用注册ClinicalTrials.gov编号，ChiCTR2200063889。2022年9月20日注册，https://www。chictr.org.cn/showproj.html?proj=174886。
