CPAP成功 | CPAP故障 | p值 | |
受试者n | 87 | 70 | |
人口统计 | |||
Males | 60(69.0) | 57(81.4) | 0.08 |
Age years | 66(56–75) | 60(51–72) | 0.08 |
>65 years | 45(51.7) | 26(27.1) | 0.07 |
>75 years | 20(23.0) | 15(21.4) | 0.82 |
BMI | 27.4(25.1–30.2) | 27.5(23.7–29.3) | 0.39 |
Obesity (BMI ≥30 kg·m-2) | 16(25.4) | 13(24.1) | 0.87 |
Current/former smoker | 17(19.5) | 10(14.3) | 0.39 |
合并症 | |||
Any cardiovascular disease | 49(56.3) | 32(45.7) | 0.19 |
Hypertension | 41(47.1) | 28(40.0) | 0.37 |
Diabetes | 24(27.6) | 12(17.1) | 0.12 |
Ischaemic cardiac disease | 19(21.8) | 8(11.4) | 0.09 |
Chronic arrhythmia | 7(8.1) | 10(14.3) | 0.21 |
Cerebrovascular disease | 9(10.3) | 4(5.7) | 0.39 |
Immunosuppression | 8(9.2) | 3(4.3) | 0.35 |
COPD | 7(8.1) | 3(4.3) | 0.51 |
Chronic renal failure | 6(6.9) | 3(4.3) | 0.73 |
Liver disease | 5(5.8) | 4(5.7) | 1.00 |
Asthma | 1(1.29 | 2(2.9) | 0.59 |
放射学 | |||
Consolidation on chest radiograph | 66(75.9) | 58(82.3) | 0.29 |
Pleural effusion | 15(17.2) | 11(15.7) | 0.80 |
药理治疗 | |||
Treatment with immunomodulators | |||
None | 56(64.4) | 42(60.0) | 0.74 |
Anakinra | 26(29.9) | 22(31.4) | |
Tocilizumab | 5(5.8) | 6(8.6) | |
Hydroxychloroquine | 84(96.6) | 68(97.1) | 0.83 |
Lopinavir/ritonavir | 48(55.2) | 37(52.9) | 0.77 |
Remdesivir | 2(2.3) | 3(4.3) | 0.66 |
Endovenous steroids | 37(42.5) | 35(50.0) | 0.42 |
Antibiotics | 84(96.6) | 66(94.3) | 0.49 |
Anticoagulation | 24(27.9) | 21(30.4) | 0.73 |
疾病的严重程度 | |||
Severe pneumonia | 56(64.4) | 55(78.6) | 0.05 |
Septic shock vasopressor | 3(3.5) | 2(2.9) | 1.00 |
Aggressive fluid resuscitation | 2(2.3) | 0(0.0) | 0.50 |
CPAP治疗前的临床变量t | |||
Confusion | 7(8.1) | 2(2.9) | 0.30 |
Temperature C (n=153) | 37.3±1.1 | 37.6±0.9 | 0.12 |
Systolic blood pressure mmHg (n=156) | 130(115–140) | 130(120–140) | 0.87 |
Diastolic blood pressure mmHg (n=156) | 75(70–85) | 80(70–85) | 0.69 |
Heart rate bpm (n=156) | 88.3±15.6 | 86.5±14.5 | 0.47 |
Respiratory rate breaths·min-1(n = 153) | 28(24–32) | 25.5(21–30) | 0.09 |
Respiratory rate ≥30 breaths·min-1 | 37(43.5) | 20(29.4) | 0.07 |
spo2%(n = 154) | 93(89–97) | 95.5(90–97) | 0.41 |
CPAP治疗前的血液分析 | |||
pH (n=155) | 7.48(7.45–7.51) | 7.47(7.45–7.50) | 0.91 |
pACO2MMHG(n = 157) | 33.0±5.0 | 32.9±5.9 | 0.89 |
pAO2MMHG(n = 157) | 65(53-83) | 75.5(60–96) | 0.009 |
pAO2:Fio2比率(n = 157) | 136(95.0–204.8) | 152(100–202) | 0.85 |
pAO2:Fio2比率类 | |||
pAO2:Fio2比率≤100mmHg | 23(26.4) | 18(25.7) | 0.90 |
100 mmHg <pAO2:Fio2比率≤200mmHg | 39(44.8) | 34(48.6) | |
200 mmHg <pAO2:Fio2比率≤300mmHg | 25(28.7) | 18(25.7) | |
CPAP治疗前的血液检查 | |||
White blood cells cell·mm-3(n = 156) | 7060(5550–9630) | 8000(5490–10 450 | 0.45 |
Platelets cell·mm-3(n = 155) | 227 00(169 000–336 000) | 19.9 000(142 000–264 500) | 0.02 |
D-dimer µg·L-1(n = 126) | 793(561.0–1242.5) | 1098(667–2444) | 0.03 |
Ferritin µg·L-1(n = 123) | 1484(832–2732) | 1558.5(1049–2830) | 0.54 |
IL-6 ng·L-1(n = 125) | 46.6(19-75) | 134(77.9–266) | <0.0001 |
C-reactive protein, mg·dL-1(n = 157) | 13.6(8.4-44.0) | 15.6(10.8–25.8) | 0.49 |
CPAP启动和治疗 | |||
Fio2%(n = 154) | 50(50–60) | 60(50–70) | <0.0001 |
PEEP cmH2o(n = 154) | 10.4±2.2 | 11.4±2.4 | 0.01 |
Increase ofpAO2:Fio2氧疗法与CPAP的比率至少为20% | 53(64.6) | 33(48.5) | 0.047 |
Increase ofpAO2:Fio2氧疗法与CPAP的比率至少为30% | 51(62.2) | 27(39.7) | 0.006 |
Days of CPAP treatment (n=153) | 8(5-14) | 4(3-7) | <0.0001 |
CPAP并发症 | |||
Pneumothorax | 0(0.0) | 1(1.4) | 0.45 |
Pneumomediastinum | 0(0.0) | 2(2.9) | 0.20 |
Haemodynamic instability | 0(0.0) | 9(12.9) | 0.001 |
Intolerance# | 10(11.5) | 11(15.7) | 0.44 |
Ulcer | 2(2.3) | 0(0.0) | 0.50 |
研究结果 | |||
Weaning from CPAP to oxygen therapy | 84(96.6) | 6(8.6) | <0.0001 |
Days from CPAP initiation to weaning to oxygen therapy (n=87) | 7(4-12) | 7(1-8) | 0.31 |
Intubation | 0(0.0) | 34(48.6) | <0.0001 |
Days from CPAP initiation to intubation (n=34) | 3(2-5) | ||
Mortality in HDU | 0(0.0) | 36(51.4) | <0.0001 |
Days from CPAP initiation to HDU mortality (n=36) | 5(3-10) | ||
Length of hospitalisation (n=138) | 18(14–25.5) | 8(4-22) | <0.0001 |
In-hospital mortality | 0(0.0) | 45(64.3) | <0.0001 |
Days from CPAP initiation to in-hospital mortality (n=45) | 0(0-0) | 6(4-11) |
数据表示为n(%),中值(四分位间范围),平均值±SD, 除非另有说明。BMI:体重指数;BPM:每分钟节拍;spo2:通过脉搏血氧饱和度测量的氧饱和度;pACO2:动脉二氧化碳张力;pAO2:动脉氧张力;Fio2:灵感氧分数;IL:白介素;窥视:正急血压力;HDU:高依赖单元。#:其中,四名患者中断了头盔CPAP。