高剂量静脉注射 Askorbic 酸对败血症和败血症休克期间的微循环和内皮糖的作用:一项双盲,随机,安慰剂控制的双盲研究
Egle Belousoviene1, Zivile Pranskuniene2,3, Egle Vaitkaitiene4
1Department of Intensive Care Medicine, Lithuanian University of Health Sciences, Eiveniu g. 2, Kaunas, LT-50161, Lithuania.
BMC anesthesiology
|September 12, 2023
概括
高剂量静脉注射的维生素C (甲酸) 在败血症患者中改善了微循环和葡萄糖. 这种干预表明,透小血管的比例更高,毛细血管的透边界区域减少.
科学领域:
- 关键护理医学 关键护理医学
- 血管生物学 血管生物学
- 营养科学 营养科学
背景情况:
- 败血症显著损害了微循环,并损害了内皮糖体.
- 之前的动物研究表明,维生素C对微循环和毒症中葡萄糖的完整性有益.
- 在人类败血症患者中高剂量静脉注射 Askorbic 酸的疗效仍在研究中.
研究的目的:
- 评估高剂量静脉注射 Askorbic 酸 (AA) 对败血症患者的微循环和葡萄糖的影响.
- 为了确定AA的使用是否改善了 perfused 小血管的比例和 glycocalyx 厚度.
- 评估AA的安全性和有效性,作为早期败血性休克的辅助疗法.
主要方法:
- 一个随机,双盲,安慰剂对照试验,涉及23名败血症患者.
- 在96小时内给予高剂量的静脉输入AA (50毫克/千克每6小时) 或安慰剂.
- 使用Cytocam-incident暗场 (IDF) 显微镜和通过GlycoCheck软件评估葡萄糖杯的完整性.
主要成果:
- 与安慰剂相比,AA组的干预后6小时观察到透小血管 (PPV) 的比例显著更高.
- 第一次剂量后,AA组的毛细血管 (5-9微米直径) 中的下部 perfused 边界区域,是糖核体厚度的指标.
- 在AA治疗后,微循环功能和葡萄糖参数的早期改善得到了观察.
结论:
- 高剂量的腹腔灌输 Askorbic 酸显示了一种趋势,即在败血性休克的早期阶段,改善微循环和葡萄糖的完整性.
- 静脉注射AA可能是一种有前途的治疗策略,用于在败血症中保持微血管功能.
- 需要进一步的研究来证实这些发现,并确定最佳剂量和持续时间.
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