用维生素C,皮和提氨酸对患有败血症的儿童进行复苏:多中心随机试点研究
Luregn J Schlapbach1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16, Sainath Raman1,2, David Buckley4
1Child Health Research Centre, The University of Queensland, Brisbane, QLD, Australia.
概括
这项试点研究发现,给患有败血性休克的儿科重症监护病房患者注射维生素C,皮和硫胺是可行的. 需要进一步的研究来确定干预措施.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 败血栓冲击管理管理
- 辅助疗法是一种辅助疗法.
背景情况:
- 有限的随机对照试验 (RCT) 数据存在于辅助维生素C,皮和胺在儿科败血症休克.
- 之前在成年人身上进行的研究表明了潜在的益处,需要进行儿科调查.
- 儿童的败血栓休克需要有效和安全的治疗策略.
研究的目的:
- 评估给患有败血性休克的儿科重症监护室 (PICU) 患者注射维生素C,皮和硫胺的可行性.
- 探索这种辅助疗法与没有器官功能障碍的改善生存率之间的关联.
- 为了告知一个更大的,最终的随机对照试验的设计.
主要方法:
- 在澳大利亚和新西兰的六个PICU进行了一项开放标签,并行,试点随机对照试验 (RCT).
- 符合条件的患者 (28天至18岁) 患有需要血管活性药物的败血性休克被随机分配 (1:1) 接受干预或标准护理.
- 主要终点是可行性,次要临床终点包括无器官功能障碍的生存率,冲击逆转和干预疗效代理.
主要成果:
- 证明了可行性,78%的符合条件的患者同意,91%的接近的父母同意.
- 在干预组 (20.0天) 和标准护理组 (21.0天) 之间,无器官功能障碍的中位生存时间是可比的.
- 两组之间的冲击逆转时间没有显著差异,尽管干预组显示出更快解决的趋势.
结论:
- 涉及高剂量的维生素C,皮和胺的辅助治疗方案在患有败血症的儿童中是可行的,需要血管压缩剂.
- 这项研究提供了有价值的数据,用于完善协议,以获得更大,更强大的RCT.
- 需要进一步的研究,以确定这种组合治疗在儿科败血症休克中的有效性和最佳使用.
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