在重症监护室治疗神经的预防性黑色素:随机对照试验的更新系统审查和元分析
Ramkumar Mukundarajan1, Kapil Dev Soni2, Anjan Trikha3
1Department of Anaesthesiology, All India Institute of Medical Sciences, New Delhi, India.
概括
预防性黑激素并没有显著降低ICU中的妄想发病率或严重程度. 虽然它没有影响ICU/住院长度或机械通风需求,但它确实缩短了通风持续时间.
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.
- 重症监护病房 (ICU) 管理管理
背景情况:
- 痴呆症在重症患者中很普遍,在ICU的发病率为45-83%.
- 之前的试验表明,黑激素和黑激素药物可以减少妄想发病率.
研究的目的:
- 评估预防性黑激素在减少妄想发病率和严重性的有效性.
- 评估黑激素对ICU/住院时间,机械呼吸和ICU死亡率的影响.
主要方法:
- 一个系统的搜索确定了随机对照试验,将黑激素与安慰剂或标准治疗进行比较.
- 使用Review Manager (RevMan 5.4) 进行数据综合,将结果报告为平均差异或风险比率.
主要成果:
- 对12项研究的元分析没有发现妄发病率 (OR 0.63;p=0.22) 或严重程度 (MD 0.22;p=0.78) 的显著降低.
- 黑素没有显著影响ICU LOS (MD 0.05; p=0.89),医院 LOS (MD -1.46; p=0.35),或需要机械通风 (OR 0.74; p=0.37).
- 观察到机械通风持续时间显著减少 (MD -0.85;p=0.03).
结论:
- 预防性黑激素似乎没有显著降低狂妄发病率,严重程度,ICU/医院LOS或ICU死亡率.
- 需要进一步的研究来澄清黑激素在ICU痴呆症管理中的作用.
- 机械通风持续时间的显著减少被注意到,这表明在这个特定的结果中存在潜在的益处.
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