静脉注射药物管理的闭环系统的性能:随机对照试验的系统审查和元分析
Ana Spataru1,2, Paola Eiben3, Annette Pluddemann4
1Department of Neurocritical Care, Southampton General Hospital, Hampshire, SO164YO, UK. ana.spataru@nhs.net.
Journal of clinical monitoring and computing
|September 11, 2023
概括
闭环药物输送系统显示出在某些药物治疗期间改善血液动力学控制和减少恢复时间的潜力. 然而,证据质量较低,表明需要进一步研究它们的风险-收益概况.
科学领域:
- 麻醉学和重症监护医学
- 生物医学工程 生物医学工程
- 药理学 药理学是指药理学的学科.
背景情况:
- 闭环药物输送系统提供基于生理反的自动化药物管理.
- 目前关于它们与手工方法相比有效性的证据有限,风险效益概况不确定.
- 这些系统主要是研究工具,需要严格的评估.
研究的目的:
- 系统地比较闭环药物递送系统与成年患者手动静脉注射药物递送系统的性能.
- 评估闭环系统对各种麻醉剂和重症监护机构的血液动力稳定性和恢复时间的影响.
主要方法:
- 进行了随机对照试验 (RCT) 的系统审查和元分析.
- 在 MEDLINE,CENTRAL 和 Embase 进行了搜索,截至 2022 年 11 月.
- 包括的研究比较了闭环和手动静脉注射药物在手术内或重症监护室的设置.
主要成果:
- 分析了32项涉及普罗波福,诺拉德林,烯,胰岛素,神经肌肉阻断剂和血管扩张剂的研究.
- 闭环系统显示,对于诺亚上腺素和血管扩张剂,血压目标之外的时间减少了.
- 对于普罗波和神经肌肉阻断剂的闭环系统,观察到更短的恢复时间.
- 大多数研究都有中等到高的偏差风险,大多数结果的证据确定性低到非常低.
结论:
- 闭环技术可能会提高在诺拉上腺素和血管扩展剂输注期间的血液动力学管理.
- 这些系统在缩短麻醉后恢复时间方面表现有前途.
- 需要进一步进行高质量的研究,以确定明确的风险-益处概况和临床效用.
相关概念视频
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