在新生儿低血压中使用皮质类固醇:对加拿大新生儿科医生的调查
Ashraf Kharrat1, Yenge Diambomba1, Amish Jain2
1Department of Paediatrics, Mount Sinai Hospital, Toronto, ON, Canada; Department of Paediatrics, University of Toronto, Toronto, ON, Canada.
Pediatrics and neonatology
|February 22, 2024
概括
对于新生儿低血压的皮质类固醇使用在加拿大新生儿科医生之间存在很大差异. 大多数受访者都同意,需要进行临床试验,以标准化新生儿低血压的治疗.
科学领域:
- 新生儿科学 新生儿科学
- 儿科重症监护 儿科重症监护
- 药理学 药理学是指药理学的学科.
背景情况:
- 新生儿低血压是重症新生儿的常见和严重疾病.
- 皮质类固醇用于管理新生儿低血压,但它们的最佳用途尚未明确定义.
- 需要了解当前的处方实践和观点.
研究的目的:
- 评估新生儿科医生关于新生儿低血压时使用皮质类固醇的现有处方做法.
- 了解新生儿科医生对说明,剂量和进一步研究的需求的看法.
主要方法:
- 进行了基于问卷的横截面电子调查.
- 该调查针对加拿大的新生儿重症监护病房的新生儿科医生 (n=206).
- 达到了33%的响应率,完成了72项调查.
主要成果:
- 在皮质类固醇指示,加重剂量 (39%使用) 和维持剂量 (0.5-1 mg/kg q6h) 中存在显著的变化.
- 治疗前的皮质醇测量切断值对于皮质素启动有很大的差异 (<100至<500nmol/L).
- 92%的受访者认为需要对新生儿低血压进行皮质类固醇随机对照试验.
结论:
- 目前在三级新生儿科医生中对新生儿低血压的皮质类固醇处方做法高度变化.
- 这些发现强调了需要标准化指导方针和进一步研究,特别是临床试验.
- 这项调查提供了有价值的数据,为未来的研究和临床实践提供信息,以管理新生儿低血压.
相关概念视频
01:25Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids
247
Inhaled corticosteroids (ICS) are anti-inflammatory drugs used primarily in treating persistent asthma and providing long-term maintenance. They target the bronchial mucosa, the lining of the airways, to control inflammation, a critical factor in asthma progression and exacerbation.
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
247
01:21Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
119
Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
119
01:26COPD: Management Using Bronchodilators and Corticosteroids
206
Chronic obstructive pulmonary isease (COPD) involves a group of progressive lung disorders characterized by persistent airflow limitation and chronic respiratory symptoms. Asthma-COPD Overlap Syndrome (ACOS), encompassing features of both asthma and Chronic obstructive pulmonary disease (COPD), is a group of progressive lung disorders that includes chronic bronchitis, emphysema, and refractory (non-reversible) asthma. ACOS leads to complex clinical presentations that combine the inflammatory...
206
01:21Factors Affecting Drug Response: Overview
2.0K
When it comes to infants and young children, they are typically administered smaller doses of medication in comparison to adults. This is primarily because their organ functions still need to fully develop, meaning their bodies are not as efficient at metabolizing or eliminating drugs. Additionally, their blood-brain barrier is more permeable than in adults. As a result, high concentrations of drugs can easily penetrate the central nervous system (CNS), potentially leading to neurological...
2.0K
01:11Renal Failure: Dose Adjustments
89
In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
89
01:27Adrenergic Antagonists: Pharmacological Actions of β-Receptor Blockers
803
β-receptor blockers significantly impact the cardiovascular system by counteracting catecholamine-induced sympathetic responses. These medications decrease heart rate, contractility, and cardiac output, potentially leading to cardiac depression, life-threatening bradycardia, and death. Therapeutically, β-blockers function as mild antihypertensives and are utilized in treating angina pectoris and cardiac arrhythmias. However, nonselective β-blockers inhibit β2-receptors in...
803