长时间或间歇性β-lactam输液在败血症:一个系统的审查和随机对照试验的元分析
Yang Zhao1, Bin Zang2, Qian Wang3
1Department of Critical Care Medicine, Shengjing Hospital of China Medical University, 36 Sanhao Street, Shenyang, 110000, China.
Annals of intensive care
|February 18, 2024
概括
长时间输注β-乳酸抗生素显著降低死亡率,并改善毒症患者的临床成功. 这种策略是安全有效的,为间歇性输液提供了更好的替代方案.
科学领域:
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
- 关键护理医学 关键护理医学
背景情况:
- 关于在败血症中最佳的β-lactam抗生素输液策略存在争议.
- 以前对长时间输注和间歇输注的研究得出了不一致的结论.
研究的目的:
- 评估长时间或间歇性β-lactam输液在成人败血症患者的疗效和安全性.
- 进行随机对照试验的系统审查和元分析.
主要方法:
- 在PubMed,EMBASE和Cochrane图书馆数据库中进行系统搜索.
- 随机效应模型用于分析死亡率,临床成功,微生物学成功和不良事件.
- 进行子组分析,以探索影响死亡率的因素.
主要成果:
- 长时间输注显著降低了全因死亡率 (RR 0.83),并改善了临床成功 (RR 1.16).
- 没有观察到微生物学成功或不良事件的显著差异.
- 亚组分析显示,在采用较大样本的大小,2010年后的研究,格拉姆阴性感染,加载剂量和青素使用的研究中,有好处.
结论:
- 长时间的β-乳酸输液在败血症管理中优于间歇性输液.
- 这一策略降低了死亡率,并提高了临床成功,而不会增加不良事件.
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