VasopressinI作为一个S第二线VasoPressor在早期的SepticShock (VISPSS) 的开始
David Ragoonanan1, Paige Nickelsen2, Nicolas Tran3
1Department of Pharmacy Services, Sarasota Memorial Hospital, Sarasota, FL, USA.
Journal of intensive care medicine
|September 16, 2023
概括
在败血性休克管理中,在较低的诺上腺素剂量中更早地开始使用血管压缩剂,并没有缩短血管压缩剂的持续时间,但确实减少了液体平衡. 这一发现影响了对感染性休克治疗的临床决策.
科学领域:
- 关键护理医学 关键护理医学
- 药理学 药理学是指药理学的学科.
- 紧急医疗 紧急医疗
背景情况:
- 血管压素是治疗败血症休克的推第二线药物.
- 压素的最佳时间和剂量尚不清楚.
- 这项研究调查了血管压素定时和上腺素剂量对结果的影响.
研究的目的:
- 评估 Vasopressin 启动时间对败血症休克的临床结果的影响.
- 评估在输血压素开始时的诺拉上腺素 (NE) 剂量对患者结局的影响.
主要方法:
- 多中心,回顾性,对败血症休克患者的观察性研究.
- 患者按 NE-相当剂量 (NEE) 在输血压剂开始时分组 (<0.25对比≥0.25mcg/kg/min).
- 倾向性得分匹配用于比较结果,包括时间到血管压缩剂停止和流体平衡.
主要成果:
- 两组之间暂停血管压缩剂的时间没有显著差异.
- 在72小时内观察到较低的液体平衡,当静脉压素在NEE开始时<0.25 mcg/kg/min.
- 较早的血管压素开始 (4小时内) 与较短的冲击分辨时间相关.
结论:
- 以较低的NE剂量 (<0.25毫克克/公斤/分钟) 开始使用血管压剂并没有缩短血管压剂的持续时间.
- 较早的血管压素启动可能会改善冲击分辨的时间.
- 较低的NE剂量较早启动血压素时观察到较低的液体平衡.
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