早期与延迟的血管压缩剂在患有败血性休克的患者中
Toshikazu Abe1,2,3, Yutaka Umemura4,5, Hiroshi Ogura5
1Department of Emergency and Critical Care Medicine Tsukuba Memorial Hospital Tsukuba Japan.
Acute medicine & surgery
|May 30, 2023
概括
在性休克患者早期服用血管压缩剂时,死亡率没有显著差异. 然而,它可能有助于防止在败血症治疗期间的液体过载.
科学领域:
- 关键护理医学 关键护理医学
- 败血症研究 败血症研究
- 药理干预药理干预
背景情况:
- 败血栓冲击管理是时间敏感的.
- 血管压缩剂治疗对于血液动力学稳定性至关重要.
- 血管压缩剂启动的最佳时间仍在争论中.
研究的目的:
- 调查早期血管压缩剂启动与败血症休克的结果之间的关联.
- 为了评估早期与延迟的血管压缩剂给药对住院死亡率的影响.
- 为了探索对败血症休克患者体液平衡的影响.
主要方法:
- 在17个日本ICU进行多中心观测研究.
- 包括使用血管压缩剂治疗的成人败血症患者 (2019年7月至2020年8月).
- 早期 (≤1小时) 与延迟 (>1小时) 血管压缩剂启动的比较,使用倾向性得分加权后勤回归.
主要成果:
- 包括97名患者:67名早期,30名延迟的血管压缩剂启动.
- 住院死亡率:32.8% (早期) 与26.7% (延迟) (p=0.543) 相比.
- 对死亡率进行调整的几率比:0.76 (95% CI 0.17-3.29). 早期开始显示了一种趋势,即随着时间的推移,输液量下降.
结论:
- 研究没有就早期血管压缩剂给药对死亡率的影响得出明确的结论.
- 早期使用血管压缩剂可能有助于避免体积过载.
- 需要进一步的研究来证实早期血管压缩剂在败血症休克中使用的好处.
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