多布他明和目标导向的液体疗法,以改善深部下腹膜穿孔器 (DIEP) 片乳房重建手术中的组织氧化:随机对照试验的协议
Glenio B Mizubuti1, Anthony M-H Ho1, Rachel Phelan1
1Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, ON, Canada.
JMIR research protocols
|November 22, 2023
概括
这项研究调查了心脏输出监测和多布胺是否可以在深下腹膜穿孔器 (DIEP) 片乳房重建期间改善组织氧化. 早期结果显示没有不良影响,预计到2024年7月完成全部研究.
科学领域:
- 整形外科 整形外科 整形外科
- 手术瘤学手术瘤学
- 关键护理医学 关键护理医学
背景情况:
- 自主乳房重建,特别是深下腹膜穿孔器 (DIEP) ,提供了自然的结果,但由于 perfusion 差,风险妥协.
- 通过外科手术期间的策略来增强片组织的氧化,对于成功的DIEP片手术至关重要.
- 目前的流体治疗缺乏客观指导,导致不同的临床结果.
研究的目的:
- 为了评估微创心输出 (CO) 监测指南是否能改善DIEP片乳房重建中的组织氧化.
- 评估这种综合方法在提高片可行性方面的安全性和有效性.
主要方法:
- 一项随机对照试验比较了CO导向液体疗法加多布他与DIEP片手术患者的标准护理.
- 通过近红外光谱测量的组织氧化是主要结果.
- 监测包括血液动力学,片氧化和术后多达48小时的并发症,并对再住院和患者满意度进行30天的随访.
主要成果:
- 由于COVID-19大流行,研究招聘推迟了,截至2023年10月,已有34名参与者报名参加研究.
- 该研究预计将于2024年7月完成.
- 参与者没有报告任何不良反应或并发症;患者遵守和随访率很高.
结论:
- 结合低剂量多布胺的CO指导液体疗法显示出改善DIEP片组织氧化和减少并发症的潜力.
- 虽然这项研究正在进行中,并且是盲目的,但最初的安全数据令人放心.
- 需要进一步分析,以确认干预措施在增强组织氧化的有效性.
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