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对于患有败血症相关脑病变的患者,最佳目标平均动脉压:一个回顾性队列研究

Hongyan Peng^1,2, Zhuoxin Liang², Senxiong Zhang²

¹Department of Pediatric Intensive Care Unit, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 318 Renmin Middle Road, Yuexiu District, Guangzhou, 510120, China.

BMC infectious diseases

|September 2, 2024

概括

维持最佳的平均动脉压 (MAP) 对败血症相关脑病变 (SAE) 患者至关重要. 这项研究表明,理想的MAP目标为81.5mmHg,以减少SAE患者的死亡风险.

科学领域:

关键护理医学关键护理医学
神经学神经学
败血症研究败血症研究

背景情况:

败血症相关脑病变 (SAE) 带来了内压力和大脑自我调节的挑战.
在SAE患者中,平均动脉压 (MAP) 和死亡率之间的确切关系尚不清楚.
确定最佳的MAP目标对于改善SAE的临床结果至关重要.

研究的目的:

调查MAP与SAE患者28天和住院死亡率之间的关联.
确定一个最佳的MAP目标,用于SAE的临床管理.
为治疗SAE.的临床医生提供基于证据的指导.

主要方法:

从MIMIC-IV数据库中对3816名SAE患者进行了回顾性分析.
为了进行比较分析,将MAP分为四个四分位数进行分层.
应用受限立方线和细分考克斯回归模型来确定MAP-死亡率关系.
包含子组分析以确保结果的稳定性.

主要成果:

在SAE患者中观察到MAP和死亡风险之间的非线性关系.
最低的死亡风险与MAP水平在74.6-90.2mmHg之间相关.
确定了81.5mmHg的最佳MAP目标,低于MAP的增加与死亡率的降低相关.

结论:

在MAP和SAE患者的死亡率之间存在非线性关联.
在临床实践中,建议MAP的最佳目标为81.5mmHg.
这一发现有助于完善SAE管理的治疗策略.

关键词:

大脑的血液流动.在重症监护病房的重症监护病房.平均动脉压的平均值.死亡率死亡率死亡率败血症相关的脑病变

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