抗逆冲击治疗中的 ангиотензин II:一个匹配的分析
Lane M Smith1, Graciela B Mentz2, Milo C Engoren1
1Department of Anesthesiology, Section of Critical Care, University of Michigan, Ann Arbor, MI.
Critical care medicine
|June 28, 2023
概括
ангиотензин II 在严重休克患者中没有改善30天或90天的死亡率. 这种血管压缩剂也没有与更好的器官功能或在重症监护机构中增加不良事件的关联.
科学领域:
- 关键护理医学 关键护理医学
- 药理学 药理学是指药理学的学科.
- 腎臟病學 (nephrology) 是一種醫學.
背景情况:
- 严重的冲击需要血管压缩器支持以保持血液动力学稳定性.
- ангиотензин II 是一种强大的内源性血管压缩剂,在休克中具有潜在的治疗应用.
- 了解血管新素II在重症监护中的有效性和安全性对于患者管理至关重要.
研究的目的:
- 为了评估血管新素II与成年患者的死亡结果的关联性.
- 评估 ангиотензин II 对二次结果的影响,包括器官功能障碍和不良事件.
主要方法:
- 追溯,匹配分析,比较接受血管新生素II的患者与对照组.
- 包括入住ICU的813名需要血管压缩剂支持的成年患者.
- 30日和90日死亡率,序列器官衰竭评估得分和不良事件的比较.
主要成果:
- ангиотензин II 的使用与30天死亡率 (60%对56%,p=0.292) 或90天死亡率 (65%对63%,p=0.440) 的显著差异无关.
- 血管新素II与器官功能障碍得分或替代疗法和机械呼吸率的变化之间没有发现显著的关联.
- 动脉动脉事件的发生率在血管新素II和对照组之间是相似的 (OR,1.02;95% CI,0.71-1.48;p=0.912).
结论:
- 在患有严重休克的患者中,血管增生素II与改善的死亡率结果无关.
- ангиотензин II 在该患者队列中没有显著影响器官功能障碍或增加不良事件的发生率.
- 可能需要进一步的研究来确定特定的患者亚组,这些患者可能会受益于 ангиотензин II 治疗.
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