摘要
目的分析15例重症新型冠状病毒肺炎(COVID-19)患者使用经鼻高流量氧疗(HFNC)的效果,总结临床应用经验.方法收集2020年2月1日至3月4日武汉中心医院后湖院区重症医学科收治的15例确诊重症COVID-19患者的临床资料,分析患者的临床特征和HFNC应用效果.结果入院后5例患者给予鼻导管或面罩吸氧,10例给予HFNC.转入ICU后,3例患者立即气管插管有创通气.另12例HFNC与无创呼吸机交替治疗,7例患者好转继续HFNC;2例高龄患者因患肿瘤、合并症多拒绝气管插管而继续无创通气;3例无创通气2 h后转为有创机械通气.治愈出院9例,死亡2例,病情改善仍在普通病房观察4例.结论HFNC在重症COVID-19治疗中占重要位置,但应及时把控气管插管有创机械通气的指征和时机,避免延迟气管插管导致病死率增加.
J Objective To analyze the results of the high-flow nasal cannula therapy(HFNC)in critically ill patients with coronavirus disease 2019(COVID-19).Methods We collected the clinical data of 15 critically ill patients with COVID-19 from February 1,2020 to March 4,2020 in the department of critical care medicine of Houhu district of the Wuhan Central Hospital.The patientsz clinical characteristics and the effect of HFNC was analyzed.Results After hospitalization,5 patients received oxygenation via nasal cannula or face mask,the other 10 patients received HFNC.After transfer to ICU,3 patients were immediately ventilated with invasive endotracheal intubation.Another 12 cases were treated alternately with HFNC and non-invasive ventilation,among them 7 cases continued HFNC after improvement,2 elderly patients continued non-invasive ventilation due to the refusal of endotracheal intubation because of having tumor and more complications,and 3 patients received invasive mechanical ventilation after 2-hour non-invasive ventilation.9 patients were cured and discharged,2 died,and 4 patients were still under observation in the general ward after the improvement of their clinical situation.Conclusion HFNC plays an important role in the treatment of severe COVID-19,but the indications and timing of invasive mechanical ventilation of endotracheal intubation should be controlled in time to avoid the increased mortality caused by delayed endotracheal intubation.
作者
王毅
刘东
王昱
Wang Yi;Liu Dong;Wang Yu(Department of Critical Care Medicine,Wuwei Cancer Hospital,Wuwei 730000,China)
出处
《中国急救医学》
CAS
CSCD
北大核心
2020年第9期896-899,共4页
Chinese Journal of Critical Care Medicine
基金
武威市新型冠状病毒肺炎防治技术应急专项(wwyj202013)。
