STRESS- L ランダム化臨床試験
Tony Whitehouse1,2, Anower Hossain3, Gavin D Perkins1,3
1University Hospitals of Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Birmingham, United Kingdom.
JAMA
|October 25, 2023
まとめ
ランディオロルの注入は,静脈動脈性ショック患者の臓器不全を改善しませんでした. この研究は,ノルエピネフリンを投与している患者の心拍の管理にランディオロルが推奨されないことを示唆しています.
科学分野:
- クリティカル ケア 医療
- 薬理学について
- 心血管の生理学
背景:
- セプティック・ショックは アドレナージック・ストレスを伴い 複数の臓器系に影響を与えます
- ベータブロックはカテキオラミンの効果を和らげ,セプティックショックによる死亡率を低下させる可能性があります.
- 静脈圧縮器のサポートを必要とする 性ショックの一般的な合併症です.
研究 の 目的:
- 慢性ショック患者におけるランディオロルの有効性と安全性を評価する.
- 長期にわたる血管圧縮剤治療を必要とする患者の臓器不全 (SOFAスコア) を減少させるかどうかを判断する.
主な方法:
- タキカルディアを患った126人の成人のセプティック・ショック患者のオープン・マルチセンター・ランダム化試験.
- 参加者は標準治療か,ノルエピネフリンと併用してランディオロールを注入された.
- 主要アウトカム: 14日間の連続臓器不全評価 (SOFA) の平均スコア.
主要な成果:
- 臨床試験は早期に終了されました.
- Landiololは標準治療と比較して平均SOFAスコアを有意に低下させなかった (MD,0. 75; P=. 24).
- 28日または90日間の死亡率の有意な違いはなく,有害事象の発生率は同様であった.
結論:
- ノルアピネフリンで治療された心拍動症の患者の臓器不全は,ランディオロール注入により改善されなかった.
- ランディオロルの使用は,この患者集団における心拍の管理には支持されない.
- セプティックショック管理におけるベータブロッカーの役割を明確にするためにさらなる研究が必要である.
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