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皮质类固醇在儿科的败血症休克:一个叙事审查
Immacolata Rulli1, Angelo Mattia Carcione1, Federica D'Amico1
1Neonatal and Pediatric Intensive Care Unit, University Hospital of Messina, 98124 Messina, Italy.
Journal of personalized medicine
|December 27, 2024
概括
对儿科败血症休克的皮质类固醇治疗仍然存在争议,对死亡率和严重程度的益处尚不清楚. 确定可能受益于二次上腺功能不全的儿童需要进一步的研究.
科学领域:
- 儿科重症监护医学 儿科重症监护医学
- 儿科内分泌学 儿科内分泌学
- 药理学 药理学是指药理学的学科.
背景情况:
- 皮质类固醇治疗是对儿科败血症休克的辩论治疗方法.
- 目前的指导方针提供有条件的建议,特别是对于耐火病例.
研究的目的:
- 审查当前关于皮质类固醇在儿科败血症休克中的疗效的文献.
- 评估对死亡率,疾病严重程度的影响,并确定潜在的患者子组.
主要方法:
- 从2013年到2023年进行的系统文献综述.
- 搜索了PubMed,Medline,Cochrane图书馆,Scopus使用关键词:"败血性休克"",类固醇"",儿童".
- 分析了最初识别的399篇文章中的63篇精选文章.
主要成果:
- 关于降低死亡率的证据是相互矛盾的;一些研究表明没有好处或增加死亡率.
- 皮可能会减少ICU停留时间,但对通风,无otropic支持和器官衰竭的影响有限.
- 上腺功能测试缺乏可复制性来识别类固醇反应者.
- 常见的副作用包括肌肉衰弱,高血和高血糖.
结论:
- 皮质类固醇在儿科败血症休克中的疗效尚未确定.
- 一部分患有二次上腺功能不全的患者可能会受益,但识别和治疗方案尚未确定.
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