相关实验视频
心脏外科手术内高剂量德克萨米他:一个随机对照试验
Jan M Dieleman1, Arno P Nierich, Peter M Rosseel
1Division of Anesthesiology, Intensive Care, and Emergency Medicine, University Medical Center Utrecht, PO Box 85500, 3508 GA, Utrecht, The Netherlands. s.dieleman@umcutrecht.nl.
JAMA
|November 3, 2012
概括
在心脏外科手术患者中,高剂量的德克萨米他并没有减少主要不良事件. 虽然它降低了感染和住院时间,但它并没有显著影响初级复合结果.
科学领域:
- 心脏病学 心脏病学
- 麻醉学 麻醉学
- 关键护理医学 关键护理医学
背景情况:
- 皮质类固醇在心脏手术中用于减少心肺旁路和外科创伤的炎症.
- 常规使用皮质类固醇预防重大不良事件的证据有限.
研究的目的:
- 为了确定手术内高剂量德克萨米他是否能减少接受心脏手术的患者的主要不良事件.
- 量化德克萨米他对关键临床结果的影响.
主要方法:
- 多中心,随机,双盲,安慰剂对照试验,涉及4494名成年患者.
- 患者接受了单次手术内剂量德克萨米他 (1 mg/kg) 或安慰剂.
- 主要结局是30天内死亡,心肌梗塞,中风,功能衰竭或呼吸功能衰竭的组合.
主要成果:
- 主要综合结局发生在德克萨米他组的7.0%与安慰剂组的8.5%之间 (RR,0.83;95% CI,0.67-1.01;P = .07).
- 德克萨米他与术后感染的减少,机械通风持续时间的缩短以及ICU/住院停留时间的减少有关.
- 在德克萨米他组中观察到更高的术后葡萄糖水平.
结论:
- 在心脏外科手术的成年人中,手术期间使用德克萨米他并没有显著降低30天主要不良事件的发生率.
- 德克萨米他可能有助于减少某些并发症,但不会影响总体复合主要不良事件发生率.
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