针对性心率控制在败血症休克中的临床实用性:随机对照试验的系统审查和元分析与试验序列分析
Priyankar K Datta1, Prachee Sathe2, Avishek Roy1
1Department of Anaesthesiology, Pain Medicine & Critical Care, All India Institute of Medical Sciences, New Delhi, India.
概括
针对性心率控制在败血症休克可能会降低28天的死亡率,但需要进一步的研究. 这次元分析发现,在败血症休克患者中,β-阻断剂的使用趋向于降低死亡率.
科学领域:
- 临界护理医学 临界护理医学
- 药理学 药理学是指药理学的学科.
- 心脏病学 心脏病学
背景情况:
- 由于对心脏功能的担忧,毒症的治疗传统上避免了β-阻断剂.
- 最近的证据表明,心率控制在感染性休克和持续性心跳动中具有潜在的益处.
研究的目的:
- 系统地审查和元分析针对性心率控制在患有败血性休克的患者的影响.
主要方法:
- 从2013年1月到2023年12月的随机对照试验 (RCT) 的系统审查和元分析.
- 包括患有败血性休克和持续性心力衰竭后复苏的成年患者.
- 对28天死亡率进行的试验顺序分析 (TSA).
主要成果:
- 分析了9项涉及807名参与者的研究.
- 通过针对性心率控制观察到较低28天死亡率的趋势 (RR:0.78;95% CI:0.62-0.99;p=0.04).
- 交通安全局表示,累积效应处于不确定区内;在血液动力学参数或结果中没有发现显著差异.
结论:
- 针对性心率控制似乎在败血性休克中被血液动力学容忍.
- 对死亡率的最终好处需要进一步调查,因为TSA的结果不确定.
更多相关视频
10:38Observational Study Protocol for Repeated Clinical Examination and Critical Care Ultrasonography Within the Simple Intensive Care Studies
Published on: January 16, 2019
20.1K
08:14Author Spotlight: Developing Innovative Therapeutic Strategies for Hemorrhagic Shock Research
Published on: March 22, 2024
1.1K
相关概念视频
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
299
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
299
Heart Failure Drugs: Inotropic Agents
395
Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
395
Pulse rhythm
717
Pulse rhythm refers to the pattern of pulsations within specific intervals, offering valuable insights into the regularity or irregularity of the heart's beats as observed through the pattern of pulsation within specific intervals. A regular pulse exhibits a consistent heart rate with uniform waveforms and pulsation force, variations of which can be classified as normal, weak, or bounding.
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
717
Increased pulse rate
620
Tachycardia is a condition marked by an abnormally fast or irregular heart rate, surpassing the typical resting rate. In adults, tachycardia is characterized by a pulse rate ranging from 100 to 180 beats per minute. The increased heart rate can result in inadequate blood flow to various body parts, ultimately diminishing the oxygen supply to organs and tissues.
Many factors can elevate the risk of developing tachycardia. These include advanced age, a family history of arrhythmias, and an...
Many factors can elevate the risk of developing tachycardia. These include advanced age, a family history of arrhythmias, and an...
620
Pathophysiology of Cardiac Performance
466
Typical heart performance is influenced by heart rate, rhythm, myocardial contraction, and metabolism or blood flow. The cardiac muscle exhibits distinct electrophysiological features, including pacemaker activity and calcium channel control, which play a vital role in the heart's response to various drugs. The autonomic nervous system, comprising the sympathetic and parasympathetic branches, regulates heart rate. Sympathetic activation increases heart rate, while parasympathetic activation...
466
