PDF(Pubmed)
Abstract：
This study aimed to determine the prevalence of adverse events in mechanically ventilated adults with COVID-19 who have undergone prone positioning. A total of 100 patients were included retrospectively; 60% were males, the mean age was 64.8 ± 9.1 years, and hospital mortality was 47%. In all, we recorded 118 removals of catheters and tubes in 66 patients; 29.6% were removals of a nasogastric tube, 18.6% of an arterial line, 14.4% of a urinary catheter, and 12.7% of a central venous catheter. Reintubation or repositioning of a tracheotomy tube was required in 19 patients (16.1%), and cardiopulmonary resuscitation in 2 patients (1.7%). We recorded a total of 184 pressure ulcers in 79 patients (on anterior face in 38.5%, anterior thorax in 23.3% and any extremity anteriorly in 15.2%). We observed that body weight (p = 0.021; β = 0.09 (CI95: 0.01-0.17)) and the cumulative duration of prone positioning (p = 0.005; β = 0.06 (CI95: 0.02-0.11)) were independently associated with the occurrence of any adverse event. The use of prone positioning in our setting was associated with a greater number of adverse events than previously reported. Body weight and cumulative duration of prone positioning were associated with the occurrence of adverse events; however, other factors during a COVID-19 surge, such as working conditions, staffing, and staff education, could also have contributed to a high prevalence of adverse events.
摘要：
这项研究旨在确定发生俯卧位的机械通气的COVID-19成人中不良事件的发生率。共纳入100例患者，其中60%为男性，平均年龄为64.8±9.1岁，医院死亡率为47%。总之,我们记录了66例患者中118例导管和导管的拔除；29.6％是鼻胃管的拔除，动脉管路的18.6%,14.4%的导尿管，和12.7%的中心静脉导管。19例患者（16.1%）需要重新插管或重新定位气管切开术，和心肺复苏2例（1.7％）。我们共记录了79例患者的184个压疮（38.5％的前面部，胸前部占23.3%，任何四肢前部占15.2%）。我们观察到体重(p=0.021;β=0.09(CI95:0.01-0.17))和俯卧位累积持续时间(p=0.005;β=0.06(CI95:0.02-0.11))与任何不良事件的发生独立相关。在我们的设置中使用俯卧位与比以前报道的更多的不良事件相关。体重和俯卧位累积持续时间与不良事件的发生有关；然而，COVID-19激增期间的其他因素，如工作条件，人员配备，和员工教育，也可能导致不良事件的高患病率。
