在急性缺血性中风中,正常盐水与平衡的静脉注射液:一项回顾性研究
1Emergency Medicine Physician, University of Kansas School of Medicine and Vituity, Wichita, KS, USA.
概括
对于接受血栓溶解的急性缺血性中风患者,与正常盐水相比,平衡的静脉注射液与90天残疾和出血变化的风险更高有关. 在这种患者群体中,正常盐水可能是首选的液体选择.
科学领域:
- 神经学 神经学
- 临界护理医学 临界护理医学
- 临床药房 临床药房
背景情况:
- 对于重症患者来说,最佳的静脉注射 (IV) 液体选择仍在争论中,一些证据支持平衡的解决方案而不是正常的盐水.
- 对于接受血栓溶解的急性缺血性中风患者来说,理想的IV液还没有得到很好的确立.
- 出血转变和长期残疾是急性缺血性中风管理中的重要问题.
研究的目的:
- 调查平衡晶体溶液与正常盐水之间的关联以及急性缺血性中风患者的结果.
- 为了确定IV液的选择是否会影响血栓溶解后出血转变或90天残疾的风险.
主要方法:
- 从单个学术医疗中心获得Get with the Guidelines®数据 (2015-2019) 的回顾性图表审查.
- 包括患有急性缺血性中风的患者,接受了静脉内组织等离子素激活剂 (tPA) 治疗.
- 对关键的人口,临床和治疗变量进行控制的多变量分析,以评估结果 (90天后修改的兰金级,出血转变).
主要成果:
- 在单变量 (OR 4.3) 和多变量 (OR 6.3) 分析中,暴露于平衡溶液与90天残疾增加有关.
- 在单变量分析 (OR 2.0) 中,平衡的解决方案也与更高的出血转变风险有关,但在多变量分析中,这没有达到统计学意义.
- 在这个队列中,正常的盐水给药与不良结果的风险增加无关.
结论:
- 在接受血栓溶解治疗的急性缺血性中风患者中,均衡的IV液溶液与90天残疾的风险增加有关.
- 均衡溶液与出血转化之间存在可能的关联,需要进一步调查.
- 正常的盐水可能是急性缺血性中风患者接受血栓溶解的首选输液选择,等待来自更大的前性试验的结果.
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