在心肺旁路术 (SIRS) 患者中使用甲基普雷尼索隆:一个随机,双盲,安慰剂对照试验
Richard P Whitlock1, P J Devereaux2, Kevin H Teoh3
1Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, ON, Canada; Department of Surgery, McMaster University, Hamilton, ON, Canada; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.
Lancet (London, England)
|October 14, 2015
概括
在接受心肺旁路术的高风险患者中,甲基普雷尼索隆没有显著降低30天死亡率或重大发病率. 心脏手术中的类固醇 (SIRS) 试验的结论不支持常规使用.
科学领域:
- 心脏病学
- 药理学
- 危急护理医学
背景情况:
- 心肺旁路引发全身炎症反应,增加术后的发病率和死亡率.
- 在高风险的手术患者中,类固醇可以减轻这些炎症效应.
研究的目的:
- 评估甲基普雷迪尼索隆在进行心肺绕道术的高风险患者中降低死亡率和重大发病率的疗效.
主要方法:
- 这是一项双盲随机对照试验,涉及80个中心的7507名患者.
- 在心肺绕道心脏手术期间,患者接受甲基普雷尼索隆或安慰剂.
- 主要结局包括30天死亡率和死亡或重大发病率的组合.
主要成果:
- 甲基普雷尼索隆并没有显著降低30天死亡率 (4%与5%相比),也没有显著降低死亡/重大发病率的综合结果 (24%与24%).
- 没有观察到心肌损伤,中风,功能衰竭或呼吸系统衰竭的风险有显著差异.
- 在这两组中,常见的安全结果包括感染和妄想.
结论:
- 甲基普雷尼索隆在心肺绕道术后的死亡率或重大发病率降低方面没有显著的益处.
- 心脏手术中的类固醇 (SIRS) 试验不支持对这些患者进行常规的甲基普雷尼索隆治疗.
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