| Autor: |
Fadel, Raef Ali, Scott, Ashley, Parsons, Austin, Murskyj, Ivanna, Nasiri, Nour, Abu Sayf, Alaa, Ouellette, Daniel |
| Předmět: |
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| Zdroj: |
Journal of Intensive Care Medicine; Nov2023, Vol. 38 Issue 11, p1042-1050, 9p |
| Abstrakt: |
Background: Acute respiratory distress syndrome (ARDS) with oliguria is associated with increased mortality. Interleukin-6 (IL-6) plays an integral role in the pathophysiology of both disease processes. Patients who experience severe COVID-19 have demonstrated higher IL-6 levels compared to baseline, and use of tocilizumab has demonstrated efficacy in such cohorts. We set out to investigate the relationship between tocilizumab use, COVID-19 ARDS, low urine output, and mortality. Methods: Retrospective cohort review of adult patients aged ≥ 18 years with COVID-19 and moderate or severe ARDS, admitted to the intensive care unit (ICU) of a tertiary referral center in metropolitan Detroit. Patients were analyzed based on presence of oliguria (defined as ≤ 0.7 mL/kg/h) on the day of intubation and exposure to tocilizumab while inpatient. The primary outcome was inpatient mortality. Results: One hundred and twenty-eight patients were analyzed, 103 (80%) with low urine output, of whom 30 (29%) received tocilizumab. In patients with low urine output, risk factors associated with mortality on univariate analysis included Black race (P =.028), lower static compliance (P =.015), and tocilizumab administration (P =.002). Tocilizumab (odds ratio 0.245, 95% confidence interval 0.079-0.764, P =.015) was the only risk factor independently associated with survival on multivariate logistic regression analysis. Conclusion: In this retrospective cohort review of patients hospitalized with COVID-19 and moderate or severe ARDS, tocilizumab administration was independently associated with survival in patients with low urine output ≤ 0.7 mL/kg/h on the day of intubation. Prospective studies are needed to investigate the impact of urine output on efficacy of interleukin-targeted therapies in the management of ARDS. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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