用Polymyxin B固定纤维柱进行内毒素去除疗法作为内毒性冲击的COVID-19床边策略协议
Silvia De Rosa1,2, Monica Zanella2,3, Sara Samoni2,4
1Department of Anesthesiology and Intensive Care, San Bortolo Hospital, Vicenza, Italy.
Frontiers in nephrology
|September 7, 2023
概括
聚米辛B固定纤维 (PMX-HP) 治疗可以改善特定内毒性休克患者的生存率. 早期内毒素评估和PMX-HP治疗,特别是在COVID-19患者中,可能是拯救生命的.
科学领域:
- 关键护理医学 关键护理医学
- 免疫学 免疫学 免疫学
- 传染性疾病 传染性疾病
背景情况:
- 内毒素诱导的败血症是ICU死亡的主要原因.
- 聚胺B固定纤维 (PMX-HP) 是一种已知用于内毒素去除和免疫调节的辅助疗法.
- 内毒性病症与COVID-19的病理生理学有关,增加了败血症风险.
研究的目的:
- 确定从PMX-HP治疗中受益的患者子组.
- 评估内毒素活性 (EA) 在指导PMX-HP治疗中的作用.
- 应用内毒性休克的诊断临床流程图,包括COVID-19病例.
主要方法:
- 对PMX-HP疗效的临床研究和大型随机试验的审查.
- 在性休克患者中分析内毒素水平 (EA).
- 实施用于内毒性休克管理的诊断临床流程图.
主要成果:
- 感染性休克患者的MODS> 9和EA 0.6-0.9显示PMX-HP的最大生存益处.
- 早期EA评估和有针对性的PMX-HP使用对于及时的内毒性休克治疗至关重要.
- 对包括COVID-19在内的内毒性休克应用了诊断临床流程图.
结论:
- 在精选的内毒性休克患者中,PMX-HP疗法提供了显著的生存益处.
- 对内毒素活性 (EA) 的测量对于优化PMX-HP治疗时间和患者选择至关重要.
- 将EA评估与抗生素一起纳入临床实践,可以在内毒性休克中拯救生命.
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