心脏骤停后更高或更低的血压目标:随机对照试验的元分析
Huzaifa Ahmad Cheema1, Arman Shafiee2, Mohammad Mobin Teymouri Athar3
1Department of Cardiology, King Edward Medical University, Lahore, Pakistan.
Indian heart journal
|June 16, 2023
概括
这次元分析发现,在非医院心脏骤停患者中,高血压目标与低血压目标的死亡率没有显著差异. 需要进一步的大规模试验来证实这些关于血压管理的发现.
科学领域:
- 心脏病学 心脏病学
- 临界护理医学 临界护理医学
- 紧急医疗 紧急医疗
背景情况:
- 血压管理对于医院外心脏骤停 (OHCA) 幸存者至关重要.
- 之前关于最佳血压目标的研究得出了不确定的结果.
- 缺乏实力的随机对照试验 (RCT) 的数据有限.
研究的目的:
- 在OHCA后的患者中进行更新的元分析,比较高血压和低血压目标之间的结果.
- 综合现有RCT的证据,以告知临床实践.
- 为了确定与不同血压目标相关的潜在好处或危害.
主要方法:
- 在PubMed,Embase和Cochrane图书馆进行系统的文献搜索,直到2022年12月.
- 包括四项随机对照试验 (RCT),涉及1114名患者.
- 使用RevMan 5.4进行元分析,以将95%置信区间 (CI) 的赔率比率 (OR) 和平均差异 (MD) 结合起来.
主要成果:
- 在高血压和低血压目标群体之间,所有原因的死亡率没有显著差异 (OR 1.12,95% CI:0.86至1.45).
- 在神经结果,心律失常发病率,替代疗法或神经元特异性酶水平上没有观察到显著差异.
- 在高血压目标群体中,ICU停留时间的统计显著但小幅减少.
结论:
- 目前的证据不支持在OHCA后患者中常规使用更高血压目标.
- 研究结果表明,目前的血压目标并没有显著影响主要结果.
- 为了得出明确的结论,需要更大的,设计良好的RCT,具有同质的血压目标.
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