药理干预措施,以预防被送往重症监护病房的人的上胃肠道出血:一个网络的元分析
Ingrid Toews1, Salman Hussain2, John L Z Nyirenda3
1Institute for Evidence in Medicine, Medical Center - Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany ingrid.toews@uniklinik-freiburg.de.
BMJ evidence-based medicine
|July 12, 2024
概括
几种药物有效地预防了重症监护室 (ICU) 患者的上部胃肠道 (GI) 出血. 然而,关于死亡率和不良事件等其他结果的证据仍然有限.
科学领域:
- 关键护理医学 关键护理医学
- 胃肠病学 胃肠病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 上部胃肠道 (GI) 出血是重症监护室 (ICU) 患者的重大风险.
- 药理干预通常用于预防这些高风险患者的胃肠道出血.
- 对这些干预措施的有效性和安全性的全面评估至关重要.
研究的目的:
- 系统地审查和分析药理学药剂在预防ICU患者临床重要上部胃肠道出血方面的有效性.
- 评估这些干预措施的安全性.
- 评估对其他相关结果的影响,如死亡率和医院肺炎.
主要方法:
- 进行了系统审查和频客网络元分析.
- 纳入了超过24小时的重症监护室患者的随机对照试验 (RCT).
- 使用推评估,开发和评估 (GRADE) 方法来评估证据的确定性.
主要成果:
- 分析了123项涉及46,996名参与者的研究.
- 齐米蒂丁,拉尼蒂丁,抗酸剂和糖酸盐在预防上部肠道出血方面表现出有效性 (中等确定性证据).
- 拉尼蒂丁和抗酸剂的组合显示出特别强大的预防作用 (中等确定性证据).
结论:
- 几种药理干预措施在ICU环境中可能有效防止临床上重要的上部肠道出血.
- 目前关于这些干预措施对死亡率,医院肺炎和不良事件的影响的证据有限.
- 在权衡这些干预措施的益处和危害时,应考虑个体患者的情况.
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