德克斯梅托米丁对烧伤患者体液复苏的作用
Michelle L Payne1,2, Sierra Young2, Jason Heard3,4
1Department of Pharmacy, Rhode Island Hospital, Providence, RI 02903, USA.
概括
在烧伤复苏期间使用德克斯梅德托米丁可能会增加初始液体需求,这种现象被称为液体爬行. 然而,这种效果在48小时内没有持续,也没有导致不良事件.
科学领域:
- 烧伤危急护理 烧伤危急护理
- 复苏药物是一种复苏药物.
- 药理学 药理学是指药理学的学科.
背景情况:
- 液体爬行,烧伤后过度复苏体积,是令人担忧的.
- 由于潜在的液体爬行,在复苏期间避免使用德克斯梅德托米丁等连续镇静剂.
- 德克斯梅德托米丁对液体复苏需求的影响还不清楚.
研究的目的:
- 调查使用德克斯梅德托米丁与成年烧伤患者的液体复苏需求之间的关联.
- 为了确定德克斯梅德托米丁是否会影响流体相关不良事件的发生率.
主要方法:
- 从2017年1月到2022年6月,对成人烧伤患者 (>20%的TBSA) 进行了回顾性队列研究.
- 在第一个24小时和第一个48小时内,德克斯梅德托米丁和对照组之间的液体体积进行了比较.
- 倾向匹配用于控制混变量;二级结果包括7天内与液体有关的不良事件.
主要成果:
- 德克斯梅德托米丁队列在前24小时内显示了增加的液体需求 (4.2 ± 1.7毫升/千克/%TBSA与3.6 ± 1.1毫升/千克/%TBSA,P = 0.03).
- 在48小时后,这种流体爬行差异并不显著 (P = 0.11).
- 在ARDS,延迟切切除术,腹内高血压或替代疗法等不良事件中没有发现显著差异.
结论:
- 在急性烧伤复苏期间服用德克斯梅德托米丁与最初24小时增加的液体需求有关,这表明与液体爬行有关.
- 这种增加的流体需求是暂时的,在48小时内没有持续.
- 临床意义尚不清楚,因为德克斯梅德托米丁与流体相关不良事件的增加发生率没有相关性.
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