循环利尿剂的连续输注与玻尿酸注射用于急性心力衰竭
Debar Rasoul1,2, Juqian Zhang1, Ebony Farnell3
1Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool, UK.
The Cochrane database of systematic reviews
|May 22, 2024
概括
这次审查发现,没有足够的证据来确定静脉注射循环利尿剂的持续输液或玻尿酸注射是否优于治疗急性心力衰竭 (AHF). 需要更多高质量的研究来比较这些利尿剂策略对AHF患者.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 急性心力衰竭 (AHF) 是一种危急的疾病,通常需要紧急的利尿药治疗.
- 本综述侧重于纽约心脏协会 (NYHA) 的III或IV级心力衰竭和流体过载患者.
研究的目的:
- 为了比较静脉注射连续输液与螺旋注射循环利尿剂在初始AHF治疗中的疗效.
- 评估对关键临床结果的影响,包括死亡率,住院时间和急性损伤.
主要方法:
- 系统地搜索多个数据库和临床试验注册表,直到2024年2月.
- 包括成年AHF (NYHA III-IV) 随机对照试验 (RCT),比较连续输液与玻璃循环利尿剂.
- 排除具有混因素的试验,如并发疗法或协议驱动的利尿剂剂量.
主要成果:
- 包括7个RCT和681名参与者,对几个结果进行元分析是可行的.
- 关于净体重减轻,全因死亡率,住院,再入院和急性损伤的证据显示,这两种方法之间几乎没有显著差异.
- 对大多数结果的证据确定性低至非常低,敏感性分析往往不能提供足够的证据.
结论:
- 目前的数据不足以确定循环利尿剂的连续输注或玻尿酸注射在AHF中的优越性.
- 由于严格的标准,不包括混因素和高风险试验,本次审查提供了强有力的结论.
- 需要进一步的高质量的RCT来最终比较这些利尿剂的施用策略.
相关概念视频
Heart Failure Drugs: Diuretics
363
Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
363
Heart Failure Drugs: β-Blockers
336
β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation,...
336
Heart Failure Drugs: Inotropic Agents
570
Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
570
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
421
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
421
Dosage Regimen: Fixed Dose
1.9K
Fixed-dose regimens are a common approach to administer drugs to achieve and maintain desired levels of the drug in the body. In this dosing strategy, a specific amount of medication is given at regular intervals, often multiple times a day, to ensure a consistent drug concentration in the bloodstream.
Fixed-dose regimens can be used for various routes of administration, including intravenous (IV) injections and oral medications. For IV administration, a predetermined amount of the drug is...
Fixed-dose regimens can be used for various routes of administration, including intravenous (IV) injections and oral medications. For IV administration, a predetermined amount of the drug is...
1.9K
Routes of Drug Administration: Parenteral
1.9K
The administration of drugs via parenteral routes allows for direct drug introduction into the systemic circulation, resulting in high bioavailability because the medication bypasses the harsh conditions of the gastrointestinal tract and hepatic metabolism.
The intravenous route (IV) of drug administration can be further categorized into two types. The bolus injection administers the entire dose rapidly, while an intravenous infusion slowly delivers smaller doses steadily.
The IV route is often...
The intravenous route (IV) of drug administration can be further categorized into two types. The bolus injection administers the entire dose rapidly, while an intravenous infusion slowly delivers smaller doses steadily.
The IV route is often...
1.9K


