目的:俯卧位常用于COVID-19相关肺损伤插管患者以改善氧合。在我们的机构,我们观察到其中一些患者出现严重的舌水肿。因此,我们试图确定该队列中舌水肿的发生率,以及俯卧位是否是与该并发症相关的危险因素.
方法:回顾性队列研究。
方法:对2020年3月13日至7月5日因COVID-19继发呼吸衰竭而插管的患者进行的单系统回顾性队列研究,这些患者随后在临床上出现了明显的舌水肿。
结果:260例患者在研究期间接受了COVID-19相关性呼吸衰竭的插管。158例患者(60.8%)至少经历了一次假肢发作。总共有12例患者(4.6%)出现了临床上显着的舌头水肿。12例发生舌水肿的患者中有11例(91.7%)在水肿发生之前经历了弯曲。俯卧位与舌水肿发生率增加相关(比值比[OR]7.56,95%置信区间[CI]0.96-59.46,P=.027)。在所有出现水肿的患者中,这种并发症在俯仰时或旋后不久被注意到(范围,0-4天)。舌水肿主要通过保守措施进行管理;一名患者需要气管造口术进行明确的治疗。
结论:在接受插管的COVID-19患者的亚组中似乎出现了舌水肿。它似乎与俯卧位有关,但本质上可能是多因素的。有必要对其发病率和病理生理学进行进一步调查。
方法:4喉镜,2021年。
OBJECTIVE: Prone positioning is frequently used in patients intubated for COVID-19-related lung injury to improve oxygenation. At our institution, we observed severe tongue edema develop in some of these patients. Hence, we sought to determine the incidence of tongue edema in this cohort and whether prone positioning was a risk factor associated with this complication.
METHODS: Retrospective cohort study.
METHODS: A single-system retrospective cohort study of patients intubated for respiratory failure secondary to COVID-19 who subsequently developed clinically notable tongue edema from March 13 to July 5, 2020.
RESULTS: 260 patients were intubated for COVID-19-related respiratory failure during the study period. 158 patients (60.8%) underwent at least one episode of proning. Twelve patients in total (4.6%) developed clinically significant tongue edema. Eleven of the twelve patients (91.7%) who developed tongue edema underwent proning prior to the development of edema. Prone positioning was associated with an increased incidence of tongue edema (odds ratio [OR] 7.56, 95% confidence interval [CI] 0.96-59.46, P = .027). In all proned patients who developed edema, this complication was noted during proning or shortly after supination (range, 0-4 days). Tongue edema was primarily managed with conservative measures; one patient required tracheostomy for definitive management.
CONCLUSIONS: Tongue edema appears to develop in a subset of patients with COVID-19 who are intubated. It appears to be associated with prone positioning but is likely multifactorial in nature. Further investigation into its incidence and pathophysiology is warranted.
METHODS: 4 Laryngoscope, 2021.