Comparison of the effects of etomidate, ketamine, sodium thiopental, and midazolam on the mortality of patients with COVID-19 requiring intubation.
Comparison of the effects of etomidate, ketamine, sodium thiopental, and midazolam on the mortality of patients with COVID-19 requiring intubation.
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DOI：
10.47176/mjiri.35.49
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发表时间：
2021
影响因子：
--
通讯作者：
Ghelmani Y
中科院分区：
文献类型：
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作者：
Edalatkhah A;Kazemi MR;Samadi Khorshidi F;Akhoundimeybodi Z;Seyedhosseini SM;Rostami S;Hosseini BV;Akhondi Z;Ghelmani Y
背景资料：在用于管理COVID-19患者的药物中，用于插管的诱导药物很少受到关注。本研究的目的是比较诱导药物对需要插管的COVID-19患者死亡率的影响。 研究方法：在这项回顾性研究中，所有于2020年2月至3月在亚兹德的Shahid Sadoughi和Shahid Rahnemoun医院住院并确诊为COVID-19并需要插管的患者均入选。根据插管中使用的药物类型将患者分为4组，并在研究的第一天、第二天、第四天和第七天结束时评估死亡率。使用SPSS 20进行统计分析，P值<0.05被认为是显著的。 结果：在这项研究中，76例患者进行了检查。依托咪酯组21例，氯胺酮组8例，硫喷妥钠组21例，咪达唑仑组35例。死亡率分别为25%、12.5%、14.3%和14.3%（p=0.822），分别为83.3%、12.5%、28.6%和25.7%（p=0.001），分别为83.3%、12.5%、42.9%和42.9%（p=0.015）;至第7天结束时分别为100%、25%、61.9%和65.7%（p=0.007）。入院至插管时间间隔分别为0.91±0.99、3.12±1.95、4.09±2.44和4.74±2.62天（p<0.001）。 结论：本研究结果表明，使用依托咪酯可能与COVID-19患者的死亡率较高相关。需要进一步的研究来验证本研究的结果。
Background: Among the medications administered for the management of COVID-19 patients, the induction drugs used for intubation have received little attention. The aim of this study was to compare the effect of induction drugs on the mortality of patients with COVID-19 requiring intubation. Methods: In this retrospective study, all patients who were admitted to Shahid Sadoughi and Shahid Rahnemoun hospitals in Yazd from February to March 2020 with definitive diagnosis of COVID-19 and needed intubation were enrolled. Patients were divided into 4 groups based on the type of drugs used in intubation, and mortality rate was assessed at the end of the first, second, fourth, and seventh days of the study. Statistical analyses were performed using SPSS 20 and P values <.05 was considered significant. Results: In this study, 76 patients were examined. Patients were divided into 4 groups, of which 21 were in etomidate group, 8 in ketamine group, 21 in sodium thiopental group, and 35 in midazolam group. Mortality rate in these 4 groups was 25%, 12.5%, 14.3%, and 14.3% (p=0.822), respectively at the end of the first day after intubation; it was 83.3%, 12.5%, 28.6%, and 25.7% (p=0.001), respectively, at the end of the second day; it was 83.3%, 12.5%, 42.9%, and 42.9% (p=0.015), respectively, until the end of the fourth day; it was 100%, 25%, 61.9%, and 65.7% (p=0.007), respectively, until the end of the seventh day. Admission to intubation time interval was 0.91±0.99, 3.12±1.95, 4.09±2.44, and 4.74±2.62 days, respectively (p<0.001). Conclusion: The results of this study suggest that the use of etomidate may be associated with higher mortality in COVID-19 patients. Further studies are needed to verify the results of this study.