関連する実験動画
ノルエピネフリンとドブタミンとエピネフリン単独の併用によるセプティックショックの管理:ランダム化試験
Djillali Annane1, Philippe Vignon, Alain Renault
1Raymond Poincaré Hospital (AP-HP), University of Versailles Saint Quentin, PRES UniverSud, Paris, France. djillali.annane@rpc.aphp.fr
Lancet (London, England)
|August 28, 2007
まとめ
セプティックショック管理において,エピネフリン単独は,ノルエピネフリンとドブタミンと比較して,同様の有効性と安全性を示した. この大規模な試験では,2つの治療戦略の間の28日間の死亡率に有意な差は認められませんでした.
科学分野:
- クリティカルケア・メディシン
- 薬理学 薬理学とは
- クリニック・トライアル 臨床試験
背景:
- 国際的なガイドラインでは,セプティックショックでエピネフリンよりもノレピネフリンやドーパミンが推奨されています.
- エピネフリンとノレピネフリンとドブタミンを直接評価した大規模な比較試験はありません.
研究 の 目的:
- セプティックショック患者におけるノレピネフリンとドブタミンとエピネフリン単独の有効性と安全性を比較する.
主な方法:
- 展望的,多センター,ランダム化,ダブルブラインド研究で,フランスの19のICUで330人のセプティックショック患者を対象とした.
- 患者はエピネフリンまたはノルエピネフリンとドブタミンを投与され,平均血圧≥70mmHgを維持するために定位しました.
- 主なアウトカムは28日間の全原因死亡率であり,治療意図分析が行われました.
主要な成果:
- 28日間の全原因死亡率は有意な差異はありません:エピネフリン群では40%で,ノルエピネフリンとドブタミン群では34%でした (p=0.31).
- 集中治療室からの退院,退院,90日間の死亡率は,グループ間で類似していた.
- 血液動力学的成功,血管圧縮薬の離脱,またはSOFAスコアの進行までの間に有意な差異は観察されなかった.
結論:
- エピネフリン単独およびノレピネフリンとドブタミンは,結血性ショックの管理において,比較可能な有効性と安全性を示しています.
- この研究は,感染性ショック管理において,ある治療戦略を他の治療戦略よりも好む証拠を提供していません.
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