瓦尔酸用于重症患者的过敏 Delirium 和激动症
Olivia Nuti1, Cristian Merchan2, Tania Ahuja3
1Department of Clinical Pharmacy Services, Critical Care, New York University Langone Hospital - Brooklyn, Brooklyn, NY, USA.
Journal of intensive care medicine
|December 9, 2024
概括
瓦尔酸 (VPA) 有效地降低了精神活性药物的危急病患者的 Delirium 和动荡. 这种治疗是安全的,有助于预防多药,减轻重症监护室 (ICU) 的工作负担.
科学领域:
- 关键护理医学 关键护理医学
- 神经药理学神经药理学
- 临床药房 临床药房
背景情况:
- 妄想和兴奋是重症病患在重症监护室 (ICU) 的常见并发症.
- 瓦尔酸 (VPA) 对ICU相关的妄和激动有潜在的益处,需要进一步调查.
研究的目的:
- 评估烯酸 (VPA) 在ICU成年患者中治疗过敏 Delirium 和动荡的疗效和安全性.
主要方法:
- 一项回顾性队列研究分析了2017年10月至2022年10月期间因过度活动妄想或兴奋而接受VPA治疗的重症患者的数据.
- 主要有效性指标是VPA治疗的第三天同时服用精神活性药物的减少.
- 二次结局包括药物剂量的变化和不良事件的发生率.
主要成果:
- 在VPA治疗的第3天,观察到精神活性药物的总数显著减少33% (P < .001).
- VPA降低了对镇静剂 (midazolam 相当剂) 的需求,但没有显著改变使用德克斯梅托米丁,阿片类药物或抗精神病药物的情况.
- 10毫克/公斤的VPA加载剂量减少了在第三天开始服用额外的精神活性药物的风险 (OR 2.8,P = .047),在48小时内看到了好处.
- 不良事件很少发生,仅发生在队列中的10.3%.
结论:
- 在现有的药物治疗方案中添加瓦尔酸 (VPA) 是安全的,用于治疗重症患者的过度活动妄想和兴奋症.
- VPA可以帮助预防多药,并减少与在ICU管理这些条件相关的总体工作量.
- 这些发现特别适用于心脏性休克和需要机械通风的呼吸衰竭患者.
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