埃托米达与胺用于急性病患者的快速序列输管:一个多中心随机对照试验
Patricia Jabre1, Xavier Combes, Frederic Lapostolle
1Samu 93-Equipe d'accueil (EA) 3409, Hôpital Avicenne, AP-HP, Université Paris 13, Bobigny, France.
Lancet (London, England)
|July 4, 2009
概括
胺是一种安全的替代品,以埃托米达为紧急输管在重症患者. 这项研究发现,胺在有效性方面是可比的,但与埃托米达相比,上腺功能不充分的风险较低.
科学领域:
- 临界护理医学 临界护理医学
- 紧急医疗 紧急医疗
- 药理学 药理学 是一个学科.
背景情况:
- 危急病患者通常需要紧急输管.
- 由于潜在的可逆上腺功能缺陷和增加的发病率,埃托米达的使用受到争议.
- 这项研究比较了etomidate和ketamine用于紧急内内输管.
研究的目的:
- 为了比较在重症患者的急诊内管注射中单次服用埃托米达或胺剂后的早期和28天的发病率.
- 为了评估etomidate与ketamine在这个患者群体中的安全性和有效性.
主要方法:
- 一个随机的,受控的,单盲试验,涉及655名需要镇静治疗紧急输管的患者.
- 患者接受了埃托米达 (0.3毫克/千克) 或胺酸 (2毫克/千克).
- 主要终点是在ICU的前3天内获得的最高顺序性器官衰竭评估 (SOFA) 评分.
主要成果:
- 埃托米达和胺组之间的平均最大SOFA分数没有显著差异 (p=0.056).
- 输管条件在各组之间是相似的 (p=0.70).
- 在埃托米达群中,上腺功能衰竭的发病率显著增加 (OR 6.7).
结论:
- 胺是一种安全有效的替代品,以埃托米达为危重病患者的内管道输入.
- 应该考虑服用胺,特别是在患有败血症的患者中.
- 该研究发现这两种药物都没有严重的不良事件.
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