用维生素B治疗耐火性休克12:一个叙述性综述
Courtney Wedemire1, Hamed Samavat2, Melanie Newkirk2
1Department of Dietitian Services, Abbotsford Regional Hospital, Abbotsford, British Columbia, Canada.
概括
高剂量的维生素B12,以氧巴胺的形式服用,有望降低阻断性血管扩张性休克患者的血管压缩剂需求. 然而,证据质量较低,需要进一步研究.
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:
- 血管扩张性休克,以低血压和低系统性血管抵抗为标志,通常用血管压缩剂治疗.
- 氧化和硫化有助于血管扩张性休克病理生理学.
- 目前正在研究高剂量维生素B12 (Hydroxocobalamin) 对抗这些影响的潜力.
研究的目的:
- 审查目前有关高剂量维生素B12在改善血管扩张性休克成年人血液动力学结果的有效性的文献.
- 为过去五年发表的研究提供最新的分析.
主要方法:
- 在CINAHL,PubMed,Cochrane和EMBASE数据库 (2023年5月) 中进行了全面的文献搜索.
- 纳入标准适用于过去五年内发表的研究.
- 八项研究符合本次审查的资格标准.
主要成果:
- 在包括的八项研究中,有七项报告称,在输入可胺后,血管压缩剂的需求减少.
- 并非所有患者都对氧巴胺治疗有积极反应.
- 研究结果受限于患者选择和结果评估时间的变化.
结论:
- 目前的证据表明,可胺可以改善血管扩张性休克的血液动力学参数,但证据质量较低.
- 氧巴胺用于耐火性血管扩张性休克的使用仍然被认为是研究性的.
- 较大的随机对照试验对于确认维生素B12在治疗血管扩张性休克中的作用至关重要,可能与其他疗法一起进行.
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