门到尿剂的时间和急性心力衰竭的结果:一个范围的审查
Mary-Tiffany Oduah1, Olubadewa A Fatunde2, Naba Farooqui3
1Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.
概括
对于急性心力衰竭 (HF) 的利尿剂的早期使用显示出混合的结果,但似乎是安全的. 需要进一步的大规模试验来证实HF管理中早期解压策略的好处.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
- 临床医学 临床医学
背景情况:
- 不足够的脱血是治疗急性心力衰竭 (HF) 的一个重大挑战.
- 优化门到尿剂 (D2D) 时间的概念旨在改善患者的治疗结果,但现有的试验证据是不一致的.
研究的目的:
- 系统地审查有关门到利尿剂 (D2D) 或门到塞米德时间对急性心力衰竭患者结果的影响的文献.
- 评估早期的利尿剂作为急性心力衰竭的脱血策略.
主要方法:
- 使用PRISMA-ScR指南进行了范围审查.
- 在PubMed和Scopus数据库的搜索中 (2015年1月至2023年11月) 使用了"门到利尿剂时间"和"急性心力衰竭脱血"等术语.
- 早期D2D被定义为在抵达30-120分钟内静脉注射尿剂;包括13篇英语文章.
主要成果:
- 早期服用利尿剂与减少住院死亡率和缩短住院时间有关.
- 较高的富罗塞米德剂量改善了HF症状,减少了住院治疗,尽管功能暂时下降.
- 早期使用利尿剂对长期死亡益处的证据仍然不确.
结论:
- 在急性心力衰竭中早期服用利尿剂是一种潜在的有效和安全的策略,尽管整体结果的影响是混合的.
- 进一步的大规模实用试验是有必要的,以调查D2D时间优化.
- 未来的研究应该探索以利尿剂效率为指导的剂量和组合疗法.
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