微量营养素作为重症病的治疗方法
Christian Stoppe1,2, Ellen Dresen1, Angelique de Man3
1University Hospital Wuerzburg, Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, Würzburg, Germany.
Current opinion in critical care
|March 5, 2024
概括
最近的试验表明,维生素C,维生素D和对重症患者没有明显的好处. 高剂量的维生素C可能对一些人有好处,但需要更多关于重症监护室 (ICU) 中微量营养素治疗的研究.
科学领域:
- 关键护理医学 关键护理医学
- 营养科学 营养科学
- 临床研究是临床研究.
背景情况:
- 像维生素C,维生素D和这样的微量营养素被认为可以调节炎症并改善重症患者的结果.
- 最近的大规模随机对照试验 (RCT) 质疑了这些既定信念.
研究的目的:
- 提供最近临床试验评估维生素C,维生素D和在重症患者的概述和批判性讨论.
- 评估在重症监护室 (ICU) 设置中的微量营养素的临床意义.
主要方法:
- 最近的大规模随机对照试验 (RCT) 的叙述性综述.
- 分析了对维生素C,维生素D和在重症患者群体中的影响的元分析.
- 包括专注于特定患者群体的研究,如败血症患者和心脏手术患者.
主要成果:
- 最近的大规模RCT没有证明维生素C,维生素D或对ICU患者的临床益处.
- 高剂量的维生素C在特定亚组 (败血症患者,高死亡风险的ICU患者) 中显示出潜在的益处,但在一个RCT中也报告了有害影响.
- 维生素D在最近的大型RCT中没有显示出明显的益处,尽管正在进行的试验和元分析表明静脉注射的可能性.
- 在心脏手术患者中高剂量并没有改善结果,没有观察到抗氧化或抗炎性标志物的增加.
结论:
- 目前来自大型RCT的证据不支持维生素C,维生素D或在重症患者中具有临床意义的作用.
- 需要进一步的研究来确定混因素,并优化微量营养素时间,持续时间和组合策略的作用.
- 高剂量维生素C和静脉注射维生素D的潜在益处和风险需要在特定的重症患者群体中继续进行研究.
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