大剂量酸:一个试点,单剂量,生理效应,双盲,随机,受控试验
Fumitaka Yanase1,2, Sofia Spano1, Akinori Maeda1
1Department of Intensive Care, Austin Hospital, Melbourne, VIC, Australia.
Critical care (London, England)
|October 12, 2023
概括
大剂量酸 (NaAscorbate) 在败血性休克患者的24小时尿量没有显著增加. 然而,它改善了器官功能,减少了血管压缩剂的需求,这需要进一步的研究.
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.
- 生物化学 生物化学
背景情况:
- 大剂量酸 (NaAscorbate) 在试验性败血症模型中显示出有希望的结果.
- 在人类败血症休克患者中NaAscorbate的生理效应仍然在很大程度上是未知的.
研究的目的:
- 为了研究单次大剂量NaAscorbate对感染性休克患者生理参数的影响.
- 评估NaAscorbate对尿液产量的影响,血管压缩剂的要求和器官功能.
主要方法:
- 进行了一项试点,单剂量,双盲,随机对照试验.
- 30名患有败血性休克的患者接受了巨剂量NaAscorbate或安慰剂.
- 主要结局是24小时内总尿量;次要结局包括血管压缩剂剂量和SOFA分数.
主要成果:
- 纳酸没有显著增加24小时总尿量 (P=0.051).
- 随着时间的推移,NaAscorbate的逐渐累积尿量,血管压缩剂量减少和顺序器官衰竭评估 (SOFA) 评分显著改善 (所有人P<0.001).
- 随着NaAscorbate的使用,观察到水平升高;发生过血和血液溶解的病例.
结论:
- 大剂量NaAscorbate并没有显著增加在败血症休克中累积24小时的尿量.
- 纳阿斯科伯酸盐对尿液输出动态,血管压力降低和SOFA评分随时间推移产生了显著的积极影响.
- 尽管出现过高血症等不良事件,但研究结果支持进一步谨慎地对纳酸盐在败血症休克中进行研究.
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