胺对紧急快速序列输管的影响:系统性审查和元分析
Qinxue Hu1, Xing Liu2, Tao Xu1
1Department of Critical Care Medicine, The Affiliated Hospital, Southwest Medical University, Luzhou, 646000, Sichuan, China.
BMC emergency medicine
|September 28, 2024
概括
在快速序列输管 (RSI) 中使用胺素并没有显著影响重症患者的住院死亡率. 虽然可能降低早期死亡率,但胺可能会延长ICU停留时间,需要仔细选择镇静剂.
科学领域:
- 关键护理医学 关键护理医学
- 麻醉学 麻醉学
- 药理学 药理学是指药理学的学科.
背景情况:
- 快速序列输管 (RSI) 是重症患者的关键手术.
- 在RSI期间选择镇静剂显著影响患者的结果.
- 胺对RSI死亡率的影响仍有争议,需要进一步调查.
研究的目的:
- 系统地审查和元分析胺对RSI患者住院死亡率的影响.
- 为在重症监护机构选择适当的镇静剂提供基于证据的见解.
主要方法:
- 系统地搜索MEDLINE,Embase和Cochrane控制试验中心注册表.
- 包括RCT和队列研究,比较镇静剂 (包括胺) 与记录的住院死亡率.
- 数据分析包括几率比率和死亡率和无ICU日的平均差异.
主要成果:
- 包含了15项研究,共有16,807名参与者.
- 与其他镇静剂相比,胺在住院死亡率没有显著差异 (OR 0.90,95% CI 0.72-1.12).
- 低质量的证据表明,胺可以降低7天死亡率 (OR 0.42,95% CI 0.19-0.93),但可以延长ICU停留时间 (MD -0.71,95% CI -1.38至 -0.05).
结论:
- 与其他RSI镇静剂相比,胺不会显著改变住院死亡率,生理功能或不良事件.
- 胺可以在减少早期死亡率方面提供好处,但可能会增加ICU停留时间.
- 这些发现支持在接受RSI的重症患者中进行知情的镇静剂选择.
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