Timing of Intubation and Its Implications on Outcomes in Critically Ill Patients With Coronavirus Disease 2019 Infection.
Timing of Intubation and Its Implications on Outcomes in Critically Ill Patients With Coronavirus Disease 2019 Infection.
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DOI：
10.1097/cce.0000000000000262
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发表时间：
2020-10
影响因子：
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通讯作者：
Patarroyo-Aponte G
中科院分区：
文献类型：
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作者：
Matta A;Chaudhary S;Bryan Lo K;DeJoy R 3rd;Gul F;Torres R;Chaisson N;Patarroyo-Aponte G
文本中提供了补充数字内容。在2019年冠状病毒病重症患者中，关于何时对急性呼吸衰竭患者进行插管存在相当大的争论。早期专家建议支持早期插管。然而，随着我们对这种疾病的了解越来越多，早期插管的风险与益处还不太清楚。我们报告了一项观察性研究的结果，旨在比较2019年冠状病毒病重症患者在病程早期与晚期插管的结局差异。早期插管需求定义为入院时或记录的Fio 2大于或等于0.5后2天内插管。在111例患者的最终样本中，76例（68%）需要早期插管。接受早期插管的患者的平均年龄明显较高（69.79 ± 12.15岁vs 65.03 ± 8.37岁; p = 0.038）。此外，需要早期插管的患者在入院时的序贯器官衰竭评估评分显著较高（6.51 vs 3.48; p ≤ 0.0001）。两组的结局不明确。总之，我们认为插管时间对2019年冠状病毒病肺炎患者的临床结果没有影响。
Supplemental Digital Content is available in the text. In critically ill patients with coronavirus disease 2019, there has been considerable debate about when to intubate patients with acute respiratory failure. Early expert recommendations supported early intubation. However, as we learned more about this disease, the risks versus benefits of early intubation are less clear. We report our findings from an observational study aimed to compare the difference in outcomes of critically ill patients with coronavirus disease 2019 who were intubated early versus later in the disease course. Early need for intubation was defined as intubation either at admission or within 2 days of having a documented Fio2 greater than or equal to 0.5. In the final sample of 111 patients, 76 (68%) required early intubation. The mean age among those who received early intubation was significantly higher (69.79 ± 12.15 vs 65.03 ± 8.37 years; p = 0.038). Also, the patients who required early intubation had significantly higher Sequential Organ Failure Assessment scores at admission (6.51 vs 3.48; p ≤ 0.0001). The outcomes were equivocal among both groups. In conclusion, we suggest that the timing of intubation has no impact on clinical outcomes among patients with coronavirus disease 2019 pneumonia.