患有败血症和败血性休克的危急病患者的高氧症:系统性审查
Francesca Romana Catalanotto1, Mariachiara Ippolito1,2, Alice Mirasola1,3
1Department of Surgical, Oncological and Oral Science (Di.Chir.On.S), University of Palermo, 90127, Palermo, Italy.
Journal of anesthesia, analgesia and critical care
|June 29, 2023
概括
对于患有败血症或败血性休克的患者来说,最佳的氧气目标仍然不清楚. 虽然高氧化可能具有杀菌作用,但也可能造成伤害,关于死亡率的结果有相互矛盾的证据.
科学领域:
- 关键护理医学 关键护理医学
- 肺部病理学 肺部病理学
- 传染性疾病 传染性疾病
背景情况:
- 败血症患者的高氧化可能提供杀菌效益,但会带来系统性损伤的风险.
- 在败血症中高氧的确切作用和最佳氧气标仍未确定.
- 关于败血症高氧化的现有文献需要综合来指导临床实践.
研究的目的:
- 系统地审查和总结有关败血症或败血性休克患者的高氧化现有文献.
- 评估高氧化物对临床结果的影响,特别是临床死亡率,在严重病的败血症患者中.
- 为了确定关于毒症最佳氧化策略的知识差距.
主要方法:
- 在PubMed和Cochrane图书馆进行系统的文献搜索.
- 纳入了成年患有败血症或败血性休克患者进入ICU的研究.
- 对12项研究的分析,包括随机对照试验和观察性研究,对高氧症的定义异质.
主要成果:
- 包括12项涉及15782名患者的研究;高氧症的定义有显著差异.
- 死亡率与高氧症有着不一致的关联:六项研究显示风险增加,三项研究没有发现差异,一项研究表明有保护作用.
- 大多数研究没有重大缺陷,但有一项试点研究在混调整和小组平衡方面存在局限性.
结论:
- 目前尚不清楚在败血症患者中平衡好处和风险的最佳氧气范围.
- 由于有相互矛盾的证据,对于败血症中高氧和正常的临床平衡是不确定的.
- 需要进一步的研究来确定最佳的氧化水平,持续时间和毒症的病原体特异性影响.
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