甲基普雷迪尼索隆剂量用于儿科重症喘:单中心队列研究
Corey A Fowler1, Jennifer M Ryder2, Alexa R Roberts3
1Department of Pharmacy, Johns Hopkins All Children's Hospital, St. Petersburg, FL, USA.
概括
在患有严重喘 (CA) 的儿童中,保守剂量的甲基普雷迪尼索隆 (MP) 导致治疗时间缩短和住院时间缩短. 这项研究描述了MP的剂量和结果,没有发现较低剂量的不良事件.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 药理学和治疗学 药理学和治疗学
- 呼吸系统药物 呼吸系统药物
背景情况:
- 儿童的严重喘 (CA) 需要密集管理,通常涉及静脉注射甲基prednisolone (MP).
- 儿科CA中MP的剂量策略有所不同,需要了解它们对临床结果的影响.
研究的目的:
- 描述因严重喘 (CA) 住院的儿童静脉注射甲基prednisolone (MP) 剂量方案.
- 评估不同MP剂量策略与临床结果之间的关联,包括治疗持续时间和停留时间 (LOS).
主要方法:
- 对168名儿童 (5-17岁) 进行了回顾性审查,这些儿童因CA入住了儿科重症监护室 (PICU).
- 患者接受了连续的雾化阿尔布特罗尔和至少一剂IVMP.
- 群体被定义为MP剂量:保守 (CDMP,≤0.5毫克/千克/剂量q6h) 与标准 (SDMP,>0.5毫克/千克/剂量q6h).
主要成果:
- 在168名儿童中,50名 (29.8%) 接受了CDMP,118名 (70.2%) 接受了SDMP.
- 接受CDMP治疗的儿童在连续 nebulized albuterol (12.8 vs. 17.3小时,p=0.019) 和 PICU LOS (0.9 vs. 1.2天,p=0.012) 的持续时间显著缩短.
- 没有观察到与皮质类固醇相关的不良事件;然而,调整后的模型显示,体重调整后的静脉MP剂量和PICU LOS或阿尔布罗尔持续时间之间没有关联.
结论:
- 针对儿科CA的静脉MP剂量在研究样本中显示出广泛的变异性.
- IV MP 的保守剂量与更短的治疗和住院时间有关.
- 需要进行前性,受控试验来验证这些研究结果的临床疗效和安全性.
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