這篇論文整理了義大利倫巴底大區2/20至3/18收治至加護病房1591名患者病歷資料,並追蹤至3/25。這1591名患者年齡中位數63歲,其中82%是男性;68%至少有一項共病,49%有高血壓;99%需要呼吸治療,其中88%需要呼吸器,11%則是接受非侵入性的呼吸器。吐氣末端壓力(PEEP)中位數為14 cmH2O,而89%的病人吸入氣中的氧濃度分數(FIO2)大於50%,氧合指數(動脈氧分壓與吸入氧濃度的比值,PaO2/FIO2,是診斷急性呼吸窘迫的標準之一)中位數是160。PEEP中位數在年輕(≤63歲)及老年(≥64歲)病患皆為14 cmH2O,而FIO2中位數則是年輕患者低於老年患者(60% vs. 70%),但氧合指數中位數則是年輕患者高於老年患者(156 vs. 163.5)。高血壓患者年齡大於沒有高血壓的患者(66 vs. 62歲),且其氧合指數亦較低(146 vs. 173)。直至3/25,16%已由加護病房轉出,58%患者仍在加護病房觀察,26%死亡;老年患者死亡率高於年輕患者(36% vs. 15%)。

(財團法人國家衛生研究院莊淑鈞博士 摘要整理)

Key Points

Question  What are the baseline characteristics and outcomes of patients with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection admitted to intensive care units (ICUs) in Lombardy, Italy?

Findings  In this retrospective case series that involved 1591 critically ill patients admitted from February 20 to March 18, 2020, 99% (1287 of 1300 patients) required respiratory support, including endotracheal intubation in 88% and noninvasive ventilation in 11%; ICU mortality was 26%.

Meaning  In this case series of critically ill patients admitted to ICUs in Lombardy, Italy, with laboratory-confirmed coronavirus disease 2019 (COVID-19), a high proportion required mechanical ventilation and ICU mortality was 26% as of March 25, 2020.

Author:Giacomo Grasselli, Alberto Zangrillo, Alberto Zanella,et al.
原文連結:https://jamanetwork.com/journals/jama/fullarticle/2764365

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