高剂量与低剂量松酸输注对接受心脏手术的患者需要输血和不良事件的影响:OPTIMAL随机临床试验
在PubMed上查看摘要
概括
此摘要是机器生成的。与低剂量的TXA相比,高剂量的TXA显著减少了心脏手术中的输血. 高剂量不低于安全性,没有增加诸如发作或血栓并发症等重大不良事件的风险.
科学领域
- 心血管外科
- 药理学
- 危急护理医学
背景情况
- 在心脏外科手术中减少血液流失至关重要.
- 为了平衡疗效和安全性,TXA的最佳剂量尚不清楚.
研究的目的
- 在接受心脏外科手术的患者中,高剂量与低剂量松酸的疗效和安全性进行比较.
主要方法
- 这是一项多中心,双盲,随机临床试验,涉及3079名成年患者.
- 患者接受高剂量 (30mg/ kg,维持16mg/ kg/ h) 或低剂量 (10mg/ kg,维持2mg/ kg/ h) 的TXA.
- 主要终点:全基红细胞输血率 (疗效) 和复合安全终点 (死亡率,发作,功能障碍,血栓事件).
主要成果
- 高剂量的TXA显著降低了全源红细胞输血率 (21. 8% 与 26. 0% 相比).
- 综合安全终点发生在高剂量组的17. 6% 和低剂量组的16. 8%,符合非劣质性标准.
- 发作率在各组之间是相似的 (1.0%对0.4%).
结论
- 在心脏手术过程中,高剂量的松酸在减少输血方面提供了适度,统计学上显著的好处.
- 高剂量的TXA与低剂量的TXA在主要不良事件的综合性方面没有劣势,包括死亡率,发作,功能障碍和血栓事件.
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