在重症监护期间的低血压以及死亡率和发病率:系统性审查和元分析
Jaap Schuurmans1,2, Benthe T B van Rossem1, Santino R Rellum1,2
1Amsterdam UMC location University of Amsterdam, Anesthesiology, Meibergdreef 9, Amsterdam, The Netherlands.
Intensive care medicine
|January 22, 2024
概括
在重症监护室 (ICU) 中的低血压与较高的死亡率和急性损伤 (AKI) 有关. 随着ICU住院期间低血压的严重程度和持续时间的增加,风险会增加.
科学领域:
- 关键护理医学 关键护理医学
- 腎臟病學 (nephrology) 是一種醫學.
- 心血管生理学心血管生理学
背景情况:
- 低血压或低血压是重症监护室 (ICU) 中常见的并发症.
- 低血压和患者的结果之间的关系,包括死亡率和器官功能障碍,需要进行彻底的调查.
- 了解潜在的暴露-严重性关系对于临床管理至关重要.
研究的目的:
- 综合现有的关于ICU低血压和患者结果之间的关联的文献.
- 评估低血压暴露和不良事件之间的剂量反应关系.
- 评估低血压对重症患者死亡率和发病率的影响.
主要方法:
- 在CENTRAL,Embase和PubMed的系统文献搜索到2022年10月.
- 包括在ICU停留期间报告低血压的研究和预定义的结果.
- 数据提取和偏差风险评估由两位独立审稿人进行,并对相关研究进行元分析.
主要成果:
- 包括122项研究 (176,329名患者).
- 在大多数研究中,低血压与增加的死亡率和急性损伤 (AKI) 有关.
- 分析证实了低血压和死亡率之间存在显著的关联 (OR 1.45,95% CI 1.12-1.88).
结论:
- 在ICU停留期间的低血压与死亡率和AKI的增加有关.
- 低血压的严重程度与这些不良结果的风险增加有关.
- 虽然元分析证实了死亡率的发现,但它没有证实与AKI的关联.
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