在污染冲击中染:种族和皮肤颜色很重要
Sameer Arvind Jog1, Vikram L Narasimhan1, Prasad Anant Rajhans2
1Department of Critical Care Medicine, Deenanath Mangeshkar Hospital & Research Center, Pune, Maharashtra, India.
概括
皮肤斑点在印度的败血症休克患者中不太常见,但预测死亡率,与毛细血管补充时间 (CRT) 不一样. 这项研究强调了斑点在不同人群中作为一个关键的结果预测器.
科学领域:
- 关键护理医学 关键护理医学
- 皮肤病学 皮肤病学
- 临床输血监测 临床输血监测
背景情况:
- 皮肤斑点是白人群体的败血症休克中公认的 perfusion 标志物.
- 它在肤色较暗的人群中的实用性,比如印度族裔的人群,仍然在很大程度上是未知的.
- 败血栓冲击管理需要跨越不同种族的可靠标记物.
研究的目的:
- 为了评估印度民族人口中在败血症休克时的皮肤斑点.
- 评估斑点作为结果预测器,与像毛细血管补充时间 (CRT) 这样的既定标记器相比.
- 为了研究斑点与其他生化 perfusion 参数的相关性.
主要方法:
- 对108名败血性休克患者 (菲茨帕特里克皮肤类型IV-VI) 的前性观察研究.
- 蒙蔽皮肤病学专家评估的斑点;使用von Luschan尺度进行皮肤类型分类.
- 斑点发生率和严重程度与CRT,乳酸和氧和度的比较.
主要成果:
- 在这个印度群体中,的发病率为20.3%,低于白人群体中报告的.
- 斑点动物显著预测了90天的死亡率 (斑点动物组的死亡率为90.9%,非斑点动物组为65.1%;p=0.028).
- 延迟的CRT (>3秒) 与死亡率没有相关性,与斑点不同.
结论:
- 皮肤斑点在印度的败血症休克患者中发生的频率较低,但仍然是死亡率的强有力的预测因素.
- 在这个种族群体中,形是一种比延迟CRT更可靠的结果预测器.
- 这些发现强调了在临床输液评估中考虑种族和皮肤颜色的重要性.
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