低血压预测指数指导目标导向治疗,以减少腹部重大手术期间的术后急性损伤:多中心随机对照临床试验的研究方案
Javier Ripollés-Melchor1,2,3, Laura Carrasco-Sánchez4,5,6,7, José L Tomé-Roca4,8
1Infanta Leonor University Hospital, Madrid, Spain. ripo542@gmail.com.
Trials
|April 29, 2024
概括
这项研究调查了使用低血压预测指数 (HPI) 的主动血液动力学策略是否可以在重大手术后减少急性损伤 (AKI). 早期的结果表明,在治疗术后并发症方面,有潜在的益处.
科学领域:
- 麻醉学 麻醉学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 关键护理医学 关键护理医学
背景情况:
- 急性损伤 (AKI) 是一种严重的术后并发症,影响死亡率和医疗费用.
- 术后低血压的积极管理对于减轻AKI风险至关重要.
- 目前的血液动力学策略可能无法充分预测或预防高风险手术患者的AKI.
研究的目的:
- 评估以低血压预测指数 (HPI) 为指导的预防性血液动力学策略在降低中度至重度AKI方面的有效性.
- 评估HPI指导管理对术后并发症和30天死亡率的影响.
- 探索高级血液动力学监测在重大选择性腹部手术中的临床实用性.
主要方法:
- 一个开放的,受控的,多中心的随机临床试验.
- 包括65岁以上或ASA III/IV状态接受重大选择性腹部手术的患者.
- 干预组使用HPI和先进的血液动力学变量从Hemosphere平台和AcumenIQ®传感器管理.
主要成果:
- 主要结局:手术后7天内中度至重度AKI的发生率.
- 二次结局:术后并发症和30天死亡率.
- 每天对患者进行随访,直到医院出院,以监测结果.
结论:
- 这项研究旨在证明,HPI引导的血液动力学管理可以降低AKI发病率.
- 这些发现可以为高风险手术患者改善术后护理方案提供信息.
- 这项研究强调了预测性血液动力学监测在预防手术并发症方面的潜力.
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