保持有针对性的腹腔 perfusion 压力是否会减少性休克患者的脏损伤? :一个随机,受控和开放的标签研究
Hüseyin Özkarakaş1, Zeki Tuncel Tekgül1, Murat Arslan1
1Clinic of Intensive Care, University of Health Sciences Türkiye, İzmir Bozyaka Trainig and Research Hospital, İzmir, Türkiye
Balkan medical journal
|September 18, 2023
概括
与标准的平均动脉压 (MAP) 目标相比,在重症监护病房患有败血性休克的患者中准腹腔 perfusion 压力 (APP) 有助于保持功能. 虽然功能有所改善,但死亡率在各组之间仍然相似.
科学领域:
- 关键护理医学 关键护理医学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 血液动力学 血液动力学
背景情况:
- 在ICU患者中增加的腹腔内压力 (IAP) 降低了腹腔 perfusion 压力 (APP),导致循环不充分和器官衰竭.
- 败血性休克患者特别容易受到高IAP对器官输液的影响.
研究的目的:
- 评估针对性APP策略对败血症休克患者损伤的影响.
- 评估高IAP对该患者队列死亡率的影响.
主要方法:
- 一项随机,受控,开放的标签研究,涉及72名败血症休克患者.
- 患者被分配到平均动脉压 (MAP) 目标65mmHg (MAP65组) 或APP目标>60mmHg (APP60组).
- 研究对比了淋巴细胞过率 (GFR),内使用,IAP,需要置换疗法以及30/90天死亡率.
主要成果:
- 与MAP65组相比,APP60组的GFR从第3天开始下降的速度明显较慢 (p<0.05).
- 在APP60组中,需要置换治疗的患者较少 (8.3%与22.2%相比),尽管这种差异在统计学上并不显著 (p=0.101).
- 在MAP65和APP60组之间,30天和90天的死亡率相似 (p>0.05).
结论:
- 保持有针对性的APP可能有助于减轻败血症休克患者的损伤.
- 该研究没有发现目标APP和MAP组之间的死亡率或末期功能衰竭有显著差异.
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