心力衰竭的心脏冲击的管理:一个国际RAND适当性小组
Stefan Williams1, Antonis Kalakoutas1, Segun Olusanya1
1Perioperative Medicine Department, Barts Heart Centre, St Bartholomew's Hospital, West Smithfield, London, EC1A 7BE, UK.
Critical care (London, England)
|April 2, 2024
概括
心脏衰竭与心脏性休克 (HF-CS) 在重症监护中很常见. 专家共识确定了需要更多研究的领域,特别是在HF-CS患者的初始评估,机械支持和断奶方面.
科学领域:
- 心脏病学 心脏病学
- 关键护理医学 关键护理医学
- 心血管研究研究心血管研究
背景情况:
- 带有心脏性休克 (HF-CS) 的心力衰竭现在是重症监护室入院的主要原因.
- 现有的临床指导方针和实践并没有通过专门的随机对照试验对HF-CS.得到可靠的信息.
- 急性不补偿性慢性心力衰竭是HF-CS管理的一个具体重点.
研究的目的:
- 确定心脏衰竭与心脏性休克 (HF-CS) 护理的共识和不确定性的领域.
- 引导临床实践,并为未来HF-CS临床试验的设计提供信息.
- 专注于由急性不补偿性慢性心力衰竭引起的HF-CS.
主要方法:
- 召开了一个由16名成员组成的多学科专家小组.
- 使用了经过修改的RAND/UCLA适当性方法.
- 一项包含34个陈述的调查被参与者在1-9级别上匿名评分.
主要成果:
- 20个陈述被评为适当的,14个被评为不适当的.
- 在初始评估,管理,升级到临时机械循环支持 (tMCS) 和从tMCS中断奶方面注意到不确定性.
- 只有关于胸部超声波在立即高频-CS管理中的实用性,才发现了重要的专家分歧.
结论:
- 该研究强调了需要大规模前性注册表和HF-CS临床试验的关键领域.
- 迫切需要证据可靠地告知临床实践和未来的社会指导方针HF-CS.
- 进一步的研究是必不可少的,以改善HF-CS患者的管理和结果.
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