心脏外科手术中的肺血管扩展剂和内扩展剂药物:与贝叶斯网络元分析进行系统性审查
Salvatore Sardo1, Vincenzo Francesco Tripodi2, Filippo Guerzoni1
1Department of Medical Sciences and Public Health, University of Cagliari, Monserrato, Italy.
Journal of cardiothoracic and vascular anesthesia
|August 31, 2023
概括
吸入前环素显示,在外科心脏手术期间,肺高血压的死亡率在统计上有明显的改善. 然而,证据仅限于少数事件和不准确性.
科学领域:
- 心脏病学 心脏病学
- 麻醉学 麻醉学
- 药理学 药理学是指药理学的学科.
背景情况:
- 肺高血压 (PH) 在心脏外科手术的术后设置中存在重大风险.
- 有效的药理管理术后PH对于改善患者的治疗结果至关重要.
研究的目的:
- 系统地审查和评估在接受选择性心脏手术的患者肺高血压的药理疗法的疗效.
- 评估内扩张剂和肺血管扩张剂对死亡率和其他临床结果的影响.
主要方法:
- 随机对照试验 (RCT) 的系统审查和贝叶斯网络元分析.
- 在生物医学数据库中搜索了成人心脏手术中术后使用内扩张剂和肺血管扩张剂的RCT.
- 包括28项涉及1879名患者的研究,将各种干预措施与安慰剂或标准治疗进行比较.
主要成果:
- 吸入式前环素是唯一与统计学上可辨认的住院死亡率改善相关的干预措施 (NNT ≥3.3,宽可信区间).
- 吸入的前环和氧化显示了重症监护室 (ICU) 停留时间的减少.
- 与对照组相比,没有其他干预措施表明二次结果在统计学上有显著差异.
结论:
- 吸入式前环素是唯一的药理干预措施,在心脏手术中为外科手术期间的PH进行统计支持的死亡率改善.
- 显著的局限性,包括低事件数和不准确性,影响了现有证据.
- 需要进一步进行高质量的研究来证实这些发现并指导临床实践.
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