在ICU (LIBERATE) 中早期从血管压缩器支持中释放midodrine:一个可行性研究
Sebastian J Kilcommons1, Fadi Hammal1,2, Dawn L Opgenorth1,2
1University of Alberta, Edmonton, Canada.
Pilot and feasibility studies
|December 5, 2024
概括
这项研究发现,在患有血管压缩剂依赖性休克的重症患者中,对口服米多德林的评估是可行的和安全的. 未来的试验可以利用这些发现来探索中氨酸.
科学领域:
- 关键护理医学 关键护理医学
- 药理学 药理学是指药理学的学科.
- 临床试验 临床试验
背景情况:
- 静脉静脉压缩剂是血液动力学不稳定的患者的标准.
- 口服血管压缩剂在重症监护中的有效性尚未得到充分证实.
- 口服中氨酸在血管压缩剂依赖性休克中的作用需要进一步调查.
研究的目的:
- 评估口服米多德林在患有静脉静脉压缩剂依赖性休克的重症患者中评估的可行性和安全性.
- 为未来大规模随机对照试验 (RCT) 的设计提供信息.
主要方法:
- 进行了一项单中心,盲目,随机对照试验 (RCT).
- 在重症监护室 (ICU) 患有血管压缩剂依赖性休克的患者被随机分配,接受口服米多德林或安慰剂.
- 通过招聘率,协议遵守和患者安全来评估可行性.
主要成果:
- 招募了20名患者;招募率为1.2名参与者/月,90%的患者遵守协议.
- 没有报告任何不良事件. 败血症是最常见的冲击原因.
- 中组显示了更短的ICU停留时间和更低的医院死亡率,尽管血管压缩剂的重新启动更频繁.
结论:
- 在ICU患者中评估口服米多德林与血管压缩剂依赖性休克是可行的和安全的.
- 这项试点研究为设计未来的最终RCT提供了有价值的数据.
- 米多德林可能有助于在危急病患者中进行冲击治疗.
更多相关视频
06:04Objective Nociceptive Assessment in Ventilated ICU Patients: A Feasibility Study Using Pupillometry and the Nociceptive Flexion Reflex
Published on: July 4, 2018
8.8K
06:10Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
Published on: June 12, 2021
3.2K
相关概念视频
Adrenergic Agonists: Therapeutic Uses
728
Adrenergic agonists have diverse therapeutic uses across various medical conditions and emergencies.
Emergency and Intensive Care Unit (ICU) applications: Pressor agents increase blood pressure, heart rate, and contractility in shock and organ failure situations. Dopamine can induce vasodilation and stimulate adrenoceptors. Endogenous catecholamines are effective in treating cardiogenic shock. α2-agonists like clonidine can reverse anesthesia-induced hypertension.
Allergies and...
Emergency and Intensive Care Unit (ICU) applications: Pressor agents increase blood pressure, heart rate, and contractility in shock and organ failure situations. Dopamine can induce vasodilation and stimulate adrenoceptors. Endogenous catecholamines are effective in treating cardiogenic shock. α2-agonists like clonidine can reverse anesthesia-induced hypertension.
Allergies and...
728
Cholinergic Antagonists: Therapeutic Uses
713
Antimuscarinic drugs have various therapeutic applications by inhibiting parasympathetic stimulation in different systems. Here are the key therapeutic uses of antimuscarinics:
Respiratory Tract: Ipratropium, aclidinium, and tiotropium treat asthma, chronic bronchitis, and chronic obstructive pulmonary disease (COPD). They protect against bronchoconstriction caused by irritants like cigarette smoke, sulfur dioxide, and ozone. They also help reduce nasopharyngeal...
Respiratory Tract: Ipratropium, aclidinium, and tiotropium treat asthma, chronic bronchitis, and chronic obstructive pulmonary disease (COPD). They protect against bronchoconstriction caused by irritants like cigarette smoke, sulfur dioxide, and ozone. They also help reduce nasopharyngeal...
713
Antihypertensive Drugs: Vasodilators
476
Vasodilators, primarily affecting the smooth muscles within arterial and venous walls, are commonly used for hypertension treatment. Medications such as minoxidil and hydralazine primarily target arteries and arterioles, while sodium nitroprusside acts on arterioles and venules. Minoxidil, functioning as a prodrug, is metabolized by hepatic sulfotransferase into its active form, minoxidil sulfate, after oral administration. This metabolite binds to the sulfonylurea receptor (SUR) component of...
476
Direct-Acting Cholinergic Agonists: Therapeutic Uses
689
Direct-acting cholinergic agonists have many therapeutic uses in various medical fields. Choline esters, including acetylcholine, have limited clinical utility due to their non-selectivity and short duration of action. Still, acetylcholine and carbachol are applied topically during ophthalmologic surgery to induce miosis. Pilocarpine, a muscarinic and ganglionic stimulator, effectively treats open-angle glaucoma and alleviates xerostomia and dry mouth caused by radiotherapy or Sjögren...
689
Depolarizing Blockers: Pharmocokinetics
305
Depolarizing blockers are administered through intravenous injection. Succinylcholine is the most common choice of depolarizing blockers in emergency clinical practices. Although they have a rapid onset, they readily diffuse away from the motor end plate into the extracellular fluid. They are metabolized by enzymes such as liver butyrylcholinesterase and plasma pseudocholinesterases. This produces a short duration of action, typically 5-10 minutes long, unlike nondepolarizing blockers, which...
305
Skeletal Muscle Relaxants: Therapeutic Uses
463
Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx...
463
