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维生素C对有败血症的成年人的影响:随机对照试验的元分析
Xing Luo1, Youfeng Zhu1, Rui Zhang1
1Department of Intensive Care Unit, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, China.
Frontiers in medicine
|September 18, 2023
概括
静脉注射维生素C并没有显著降低败血症患者的短期死亡率. 然而,它减少了血管压缩剂的使用,特别是在发展中国家,这表明对特定人群的潜在益处.
科学领域:
- 关键护理医学 关键护理医学
- 营养生物化学 营养生物化学
- 基于证据的医学基于证据的医学.
背景情况:
- 静脉注射 (IV) 维生素C在治疗败血症中的作用受到争议.
- 败血症是一种危及生命的疾病,其特点是由于宿主对感染的反应失调而导致器官功能障碍.
研究的目的:
- 评估IV维生素C在败血症治疗中的临床有效性.
- 分析其对死亡率,血管压缩剂使用,ICU停留和器官功能得分的影响.
主要方法:
- 一个系统的审查和随机对照试验 (RCTs) 的元分析发表到2022年11月15日.
- 搜索了主要的电子数据库,包括PubMed,Embase,Web of Science和Cochrane图书馆.
- 评估了初级结果 (短期死亡率) 和二次结果 (血管压力剂持续时间,ICU停留,SOFA得分),并根据剂量,持续时间和地区对子组进行分析.
主要成果:
- 分析了10个涉及1426名患者的RCT. 总体而言,短期死亡率,ICU停留时间或SOFA得分没有显著差异.
- 输液维生素C显著减少了血管压缩剂使用的持续时间 (MD,-14.36小时).
- 亚组分析显示,发展中国家患者的短期死亡率,血管压缩剂持续时间和SOFA得分显著降低.
结论:
- 静脉注射维生素C并没有显著改善短期死亡率或减少败血症患者的ICU停留时间.
- 维生素C显著减少了血管压缩剂使用的持续时间.
- 发展中国家的败血症患者可能会从IV维生素C治疗中获得更大的好处.
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