在重症婴儿中,结合性肺血管扩散剂治疗的药理流行病学
Karan R Kumar1,2, Elizabeth C Ciociola3, Kayla R Skinner2
1Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA.
Cardiology in the young
|October 16, 2024
概括
联合肺血管扩散疗法越来越多地用于婴儿,吸入氧化和西尔德纳菲尔是常见的. 然而,存在显著的实践差异,突出了对婴儿肺高血压最佳治疗策略的进一步研究的需要.
科学领域:
- 新生儿药理学 新生儿药理学
- 儿科重症监护 儿科重症监护
- 肺高血压研究研究
背景情况:
- 结合性肺血管扩张疗法在儿科重症监护中正在上升.
- 对肺高血压联合治疗的婴儿特异性数据仍然有限.
- 这项研究探讨了重症婴儿组合治疗的药理流行病学.
研究的目的:
- 描述结合性肺血管扩张疗法在重症婴儿的使用情况.
- 分析药物使用模式,包括频率,时间和持续时间.
- 为了比较接受组合治疗与单一治疗的婴儿的特征和结果.
主要方法:
- 一个多中心数据库 (1997-2020) 的回顾性分析.
- 包括在内生婴儿接受吸入氧化,西尔德纳菲尔,埃波普罗斯坦醇或博森坦连续2天以上的婴儿.
- 组合和单一治疗组之间的临床变量和药物使用的比较.
主要成果:
- 7681名婴儿中有9%接受了组合治疗.
- 组合疗法婴儿的妊娠年龄,出生体重较低,死亡率更高.
- 吸入的氧化和西尔德纳菲尔是最常见的;与它们的双重治疗是最常见的.
- 随着时间的推移,组合治疗的使用量增加,实践中存在显著的变化.
结论:
- 结合性肺血管扩张疗法,特别是吸入的氧化和西尔德纳菲尔,越来越多地用于婴儿.
- 临床实践中的显著差异需要进一步研究.
- 最佳的组合,序列,剂量和适用情况需要进一步调查.
相关概念视频
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
3
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
3
Acute Respiratory Failure-V
124
The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...
Ensure that patients are monitored continuously for their response to therapy, including changes in...
124
Factors Affecting Drug Response: Overview
1.9K
When it comes to infants and young children, they are typically administered smaller doses of medication in comparison to adults. This is primarily because their organ functions still need to fully develop, meaning their bodies are not as efficient at metabolizing or eliminating drugs. Additionally, their blood-brain barrier is more permeable than in adults. As a result, high concentrations of drugs can easily penetrate the central nervous system (CNS), potentially leading to neurological...
1.9K
Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists
155
Prostacyclin receptor agonists are a class of therapeutic agents integral to managing pulmonary arterial hypertension (PAH). These drugs operate by mimicking the action of prostaglandin I2, or PGI2, a naturally occurring compound in the body.
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
155
Treatment for Pulmonary Arterial Hypertension: Oxygen Therapy for Respiratory Failure
180
Oxygen therapy has emerged as a significant tool in enhancing the quality of life for patients suffering from pulmonary arterial hypertension (PAH). While this therapy has principally been studied on patients with significant hypoxemia, this therapeutic approach helps prevent potential organ damage and can be administered in the comfort of one's home.
Oxygen therapy is vital in increasing and maintaining blood oxygen levels in PAH patients. As a result, it aids in reducing fatigue,...
Oxygen therapy is vital in increasing and maintaining blood oxygen levels in PAH patients. As a result, it aids in reducing fatigue,...
180
Chronic Obstructive Pulmonary Disease-V: Management
2.5K
Managing Chronic Obstructive Pulmonary Disease (COPD) involves a multifaceted approach to reduce symptoms, prevent exacerbations, improve overall health status, and slow disease progression. Key strategies include lifestyle modifications, pharmacotherapy, supportive therapies, and, in some cases, surgery. Here is an overview of the primary COPD management strategies:
Smoking Cessation
Smoking Cessation
2.5K


