在患有低血症的重症患者中,亲肠道的管理和结果:一项回顾性队列研究
Max Melchers1,2, Hanneke Pierre Franciscus Xaverius Moonen1,2, Tessa Maria Breeman1
1Department of Intensive Care Medicine, Gelderse Vallei Hospital, 6761 EP, Ede, The Netherlands.
Journal of intensive medicine
|April 17, 2025
概括
在重症监护室 (ICU) 患有低血症的患者中,肠道并没有改善生存率或休克缓解. 事实上,它可能会增加死亡风险,特别是在有轻度低血症的败血症患者中.
科学领域:
- 关键护理医学 关键护理医学
- 重症监护病房 (ICU) 管理管理
- 电解质平衡的电解质平衡是什么
背景情况:
- 低血是重症监护室 (ICU) 患者常见的并发症.
- 在患有低血症的重症患者中使用是有争议的,因为结果数据相互矛盾.
- 缺乏对管理结果的子组分析.
研究的目的:
- 为了研究在患有低血症的危急病患者中,通过肠道给予和临床结果之间的关联.
- 分析败血症和非败血症患者组的结果.
- 为了检查对死亡率和冲击分辨率的影响.
主要方法:
- 对患有低血症的成年ICU患者进行回顾性队列研究.
- 纳入标准:入住ICU的前7天,没有脏替代疗法,ICU停留时间≥48小时.
- 主要结局:180天死亡率和震荡时间;子组分析败血症/非败血症和轻度/中度低血症.
主要成果:
- 在接受和不接受腹腔内的患者之间,180天死亡率没有显著差异 (aHR=1.18).
- 亲肠道与更短的冲击分辨时间相关 (aOR=0.81).
- 在接受 (aHR=1.8890天,aHR=1.79180天) 的轻度低血症败血症患者中观察到死亡风险增加.
结论:
- 亲肠道给药对患有低血症的ICU患者没有生存或冲击解决的好处.
- 的使用可能与死亡率的增加有关,特别是在特定的亚组,如有轻度低血症的败血症患者.
- 为了验证这些发现,需要进行进一步的研究,包括随机对照试验.
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