使用外部冷却控制发烧的协议,在机械通风患者的感染性休克:SEPSISCOOL II随机对照试验
Armelle Guénégou-Arnoux1,2, Juliette Murris3,4, Stéphane Bechet5
1INSERM CIC1418-EC, INSERM-INRIA HeKA, Université Paris Cité, Paris, France armelle.arnoux@aphp.fr.
BMJ open
|January 29, 2024
概括
这项研究调查了是否积极冷却感染性休克患者到正常温度可以提高生存率. 它将发烧治疗与冷却与前48小时没有发烧治疗进行比较,以确定治疗败血症冲击的最佳方法.
科学领域:
- 临界护理医学 临界护理医学
- 传染性疾病 传染性疾病
- 治疗方法 治疗方法
背景情况:
- 在败血症中控制发烧是常见的,但其生存益处尚不清楚.
- 患有败血症和器官衰竭的患者可能无法承受发烧的代谢需求.
- 冷却可能比抗发烧药更有效,用于控制败血症中的发烧.
研究的目的:
- 为了确定是否控制发烧到正常热量可以改善发烧性败血症患者的器官衰竭和60天死亡率.
- 为了比较活性冷却与没有发烧的治疗,在感染性休克发作后48小时内进行治疗.
- 基于SEPSISCOOL试点研究的发现.
主要方法:
- 一个务实的,适应性的,多中心的,开放的,随机对照的优越性试验 (SEPSISCOOL II).
- 患有发烧性败血症休克的患者按ARDS状态分层,随机分配到冷却或不冷却.
- 主要终点:60天死亡率. 二级终点:器官衰竭的演变,早期死亡率,耐受性. 目标样本大小:820名患者.
主要成果:
- 当研究完成并可获得结果后,该部分应填写.
结论:
- 当研究完成并可获得结果后,该部分应填写.
相关概念视频
Increased Body Temperature
A body temperature above 38°C (100.4 °F) is known as fever or pyrexia, and a person with fever is termed 'febrile.' Typically, the hypothalamus, a part of the brain that acts as the body's thermostat, regulates body temperature through a thermoregulatory setpoint. It receives signals from cold and warm thermal receptors throughout the body and adjusts the body's temperature accordingly. Fever occurs when this hypothalamic setpoint is altered, usually in response to an infection or illness.
Methods of reducing fever
The signs and symptoms of fever include hot and dry skin, flushed face, thirst, muscle aches, anorexia, headache, tachycardia, tachypnea, and fatigue. Elevated body temperature is reduced using two methods: pharmacological and nonpharmacological. Proper identification and treatment of the root cause of a fever is of utmost importance.
Pharmacological Methods of Reducing Fever:
Pharmacological Methods of Reducing Fever:
Decreased Body Temperature
A decreased body temperature can occur in patients with hypothermia and frostbite. Heat loss with extended cold exposure overpowers the body's ability to create heat, resulting in hypothermia. Core temperature readings help classify hypothermia. Mild hypothermia is temperatures between 32 °C (89.6 °F) and 35°C (95 °F) and is caused by impaired thermoregulation. Moderate hypothermia is temperatures between 28 C (82.4 °F) and 32 °C (89.6 °F) caused by sustained extreme cold exposure, and severe...
Pneumonia IV: Management
The treatment of pneumonia varies based on its severity and the causative pathogen. Here is a structured approach to managing pneumonia, integrating pharmaceutical and supportive care strategies.
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
Mechanical Ventilation II: Invasive Ventilation
Ventilators are essential medical equipment used to aid patients with respiratory difficulties. Their primary function is to assist or replace spontaneous breathing by providing mechanical ventilation. There are two general classes of mechanical ventilators: negative-pressure and positive-pressure ventilators.
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...
Physical Methods for Controlling Microbial Growth: Temperature
Heat is a widely used method to control microbial growth by targeting and denaturing cellular proteins, thereby killing or inactivating microbes. This method's effectiveness is quantified using parameters such as the thermal death point (TDP), thermal death time (TDT), and decimal reduction time (D value). TDP represents the lowest temperature at which all microorganisms in a liquid suspension are eliminated within 10 minutes, whereas TDT is the time necessary to achieve sterilization at a...


