甲胺醇和诺亚上腺素的剂量等效 - - 一个回顾性分析
Rahul Costa-Pinto1, Ary Serpa Neto2, Madeline Coxwell Matthewman3
1Department of Intensive Care, Austin Hospital, 145 Studley Road, Heidelberg, Victoria, Australia; Department of Critical Care, Department of Medicine, the University of Melbourne, Parkville, Victoria, Australia.
在重症患者中,甲胺醇与诺亚上腺素血管压缩剂的中位数剂量相当于12.5:1. 然而,存在显著的差异,在转换期间常见的低血压,突出需要仔细的定位.
科学领域:
- 临界护理医学 临界护理医学
- 药理学 药理学是指药理学的学科.
- 临床药房 临床药房
背景情况:
- 在重症监护室 (ICU) 经常使用的血管压缩剂是诺拉地林和甲胺醇.
- 有限的数据存在于metaraminol和noradrenaline之间的精确剂量等价性.
- 了解剂量等效对于在重症患者中安全有效的血管压缩剂管理至关重要.
研究的目的:
- 为了确定重症患者中甲胺醇和诺拉德林之间的剂量等效比率.
- 调查影响这种剂量相当性的因素,包括急性损伤 (AKI),败血症和机械通风.
- 评估在从甲胺醇过渡到诺亚上腺素期间低血压的发生率.
主要方法:
- 一项追溯的队列研究,涉及195名从甲胺醇转换为诺亚上腺素输注的ICU患者.
- 用最后一小时的甲胺醇和第一个小时的诺亚上腺素剂量计算剂量等效,与平均动脉压 (MAP) 相匹配.
- 对AKI,败血症和机械通风患者进行的敏感性分析.
主要成果:
- 甲氨醇与诺亚上腺素的转换比率中位数为12.5:1.
- 观察到转换比率的显著变化 (变化系数为77%).
- 在过渡期间,20%的患者出现了低血压 (>10 mmHg MAP 降低);AKI患者的转化率 (14:1) 较高.
结论:
- 甲胺醇与诺亚上腺素的中位数剂量相当于12.5:1,但患者之间存在很大的差异.
- 甲胺醇剂量是对诺亚上腺素需求的糟糕预测指标 (R-平方0.545).
- 与转换相关的低血压是常见的,这强调了需要警监测和个性化剂量策略的需要.
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