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Amaç:

Son derece bulaşıcı şiddetli akut solunum sendromu koronavirüs 2 yeni koronavirüsünün neden olduğu akut respiratuvar distres sendromu (ARDS) ile ilişkili koronavirüs hastalığı-2019 (COVID-19), pandemi döneminde önemli bir ölüm nedenidir. Burada COVID-19 ARDS hastalarında yüksek akımlı nazal oksijen (HFNO) tedavisine ekstübasyon başarısının retrospektif veri analizini sunmayı amaçlıyoruz.

Gereç ve Yöntem:

Yoğun bakım ünitesinde (YBÜ) HFNO tedavisine ekstübe edilen, laboratuvarca doğrulanmış 22 COVID-19 ARDS hastasının verileri analiz edildi. Solunumla ilgili değişkenler ve demografik özellikler başvuru sırasında toplandı. Entübasyon süresince mekanik ventilasyon hacimleri ve basınçları ile kan gazı ölçümleri kaydedildi. HFNO akış hızı, FiO₂ ve oksijenasyon değişkenleri ekstübasyondan sonra 5 gün boyunca toplandı. Planlanan ekstübasyonu takip eden 5 gün içinde yeniden entübasyon oranı, YBÜ’de kalış süresi ve mortalite kaydedildi.

Bulgular:

Yirmi iki hastanın 16’sı erkekti (%72,7) ve yaş ortalaması 69,9±13,2 yıl olup, en yüksek komorbidite hipertansiyon (%59,1) idi. Semptom başlangıcı ile YBÜ’ye kabul arasındaki süre 6,5±7,9 gündü ve hemen hemen tüm hastalar aynı gün entübe edildi. Yirmi hasta HFNO’ya başarıyla ekstübe edildi ve 2 hasta yeniden entübe edildi. Ortalama yüksek akımlı nazal oksijen tedavisi süresi 4,8±3,6 gün ve yoğun bakımda kalış süresi 17,4±6 gündü. YBÜ mortalite oranı %13,6 (3/22) idi.

Sonuç:

Ekstübasyon uygulanan yüksek riskli ARDS COVID-19 hastalarında yeniden entübasyon ve ekstübasyon sonrası solunum yetersizliğini önlemek için HFNO tedavisi düşünülmelidir.

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Yüksek Akışlı Nazal Kanül Oksijen Tedavisine Başarıyla Ekstübe Edilen COVID-19 ARDS Hastalarının Retrospektif Analizi

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References