重组人体红蛋白在重症患者中的有效性:一个随机对照试验
Howard L Corwin1, Andrew Gettinger, Ronald G Pearl
1Critical Care Medicine, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756, USA. howard.l.corwin@hitchcock.org
JAMA
|December 11, 2002
概括
每周的复合人体红色素 (rHuEPO) 显著减少了重症患者的红细胞 (RBC) 输血. 这种治疗也增加了血红蛋白水平,但没有影响死亡率或不良事件.
科学领域:
- 临界护理医学 临界护理医学
- 血液学 血液学 血液学
- 药理学 药理学是指药理学的学科.
背景情况:
- 贫血常见于重症患者,导致频繁的红细胞 (RBC) 输血.
- 人们担心,在这个人群中,红细胞输血可能会带来潜在的负面临床结果.
研究的目的:
- 评估每周一次复合人体红素 (rHuEPO) 剂量方案在重症患者中减少红细胞输血的有效性.
- 评估rHuEPO对重症监护室 (ICU) 血红蛋白水平和临床结果的影响.
主要方法:
- 一项前性,随机,双盲,安慰剂控制的多中心试验,涉及1302名重症患者.
- 患者在ICU第3天接受了40万单位rHuEPO或安慰剂,然后每周一次,每周一次,最多四次.
- 主要终点是研究28日的输血独立性;次要终点包括输血的红细胞单位,死亡率和血红蛋白变化.
主要成果:
- 接受rHuEPO治疗的患者显示,红细胞输血的发生率显著降低 (50.5%与安慰剂60.4%相比,P<.001).
- 在rHuEPO组中,总输血红细胞单位减少了19%,血红蛋白水平显著增加 (1.32g/dL对比0.94g/dL,P<.001).
- 在rHuEPO和安慰剂组之间,没有发现死亡率或不良临床事件的显著差异.
结论:
- 每周给药4万个单位的rHuEPO有效地减少异性红细胞输血和增加血红蛋白水平在危急病患者.
- 需要进一步的研究来确定观察到的红细胞输血减少是否转化为改善的临床结果.
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