在使用内分泌素受体对抗剂时预防下大脑下出血后的液体保留
Yu Okuma1, Shinobu Hirahata1, Akane Tanda1
1Department of Neurological Surgery, Sonoda Daiichi Hospital, Tokyo, Japan.
Advances in experimental medicine and biology
|October 14, 2024
概括
内分泌素受体抗剂 (ERA) 有助于预防脑下下关节出血后的延迟性脑梗塞,但可能导致液体保留. 老年患者更容易受到影响,这表明年龄是管理ERA副作用的关键因素.
科学领域:
- 神经学 神经学
- 药理学 药理学是指药理学的学科.
- 关键护理医学 关键护理医学
背景情况:
- 在下大脑下出血 (SAH) 之后的延迟脑梗塞 (DCI) 是致病率的重要原因.
- 内甲素受体对抗剂 (ERA) 是预防DCI的最新治疗选择.
- 流体保留,包括多叶膜溢出和肺,是ERA已知的副作用.
研究的目的:
- 为了研究患者特征,水分保留和SAH患者的ERA使用之间的关系.
- 在ERA治疗期间确定影响症状性液体保留 (第三液体空间) 的发展因素.
- 评估潜在的策略,以减轻ERA诱导的水分保留.
主要方法:
- 对2022年7月至12月连续10名SAH患者接受ERA (克拉索森坦) 治疗的回顾性分析.
- 包括患者的背景数据,血液采样,心声学和胸部CT发现.
- 评估术后的DCI,需要CSF分流的头,以及需要医疗干预的症状性液体保留.
主要成果:
- 该研究包括10名SAH患者 (2名男性,8名女性,平均年龄63岁).
- 一名患者患有DCI,三名患有水头,五名患有症状性液体保留 (第三种液体空间).
- 年龄是与第三流体空间相关的唯一显著因素;在老年患者中,在停止治疗ERA后注意到改善.
结论:
- 患者的年龄是影响第三流体空间并发症的危险的一个关键因素.
- 在80岁以上的患者中,避免ERA,限制输液量和早期心力衰竭管理可能会减少液体保留.
- 需要进一步的研究来优化ERA的使用,并尽量减少SAH患者的不良事件.
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