在接受气管输管治疗的重症患者中,液体输注对心血管衰竭的影响:随机临床试验
Derek W Russell1,2, Jonathan D Casey3, Kevin W Gibbs4
1Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Alabama Heersink School of Medicine, Birmingham.
JAMA
|June 16, 2022
概括
在气管输管过程中给严重病的成年人注射静脉液体并没有显著减少心血管崩. 这一发现表明,在这种患者群体中,液体补充剂不能有效预防低血压,心脏骤停或死亡.
科学领域:
- 危急护理医学
- 麻醉学
- 心血管生理学
背景情况:
- 低血压是气管输管过程中常见的一种并发症.
- 这种并发症增加了不良结果的风险,包括心脏骤停和死亡.
研究的目的:
- 调查静脉输液玻尿酸在预防严重低血压,心脏骤停和呼吸道输管过程中死亡的有效性.
主要方法:
- 这是一项随机临床试验,涉及1067名患病严重的成年人接受气管输液.
- 参与者被随机分配到500毫升静脉注射液体或没有液体注射.
- 主要结局是心血管崩,定义为血管压缩剂使用,低静脉压,心脏骤停或输液后一小时内死亡.
主要成果:
- 流体注射组 (21. 0%) 和无流体注射组 (18. 2%) 的心血管崩发生率没有显著差异.
- 在不同组中,新增或增加血管压缩剂使用率,严重低血压,心脏骤停和死亡率相似.
- 流体注射 (40. 5%) 和无流体注射 (42. 3%) 组在28天死亡率上没有显著差异.
结论:
- 静脉注射液体并没有显著降低接受气管输管治疗的危急病患者心血管崩的发生率.
- 这些发现表明,在此过程中,常规注射液体可能对预防不良血液动力学事件没有好处.
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