随着基胺的紧急快速序列诱导后诱导后低血压的发生率:系统性审查和元分析
Pedro Vila de Mucha1, Stephen Thomas2,3
1Blizard Institute, Queen Mary University of London, London, UK. pedro.vilademucha@nhs.net.
概括
在紧急快速序列诱导 (RSI) 中使用胺素并没有显著改变诱导后低血压 (PIH) 的发生率. 这次系统性审查发现,当胺与其他诱导剂相比时,PIH率没有差异.
科学领域:
- 关键护理医学 关键护理医学
- 麻醉学 麻醉学
- 药理学 药理学是指药理学的学科.
背景情况:
- 快速序列诱导 (RSI) 对重症患者至关重要.
- 诱导后低血压 (PIH) 是RSI的严重不良影响,与较差的结果有关.
- 与其他药物相比,胺被假设在紧急RSI期间减少PIH.
研究的目的:
- 系统地审查和分析胺对紧急RSI期间PIH发病率的影响.
- 为了评估胺在预防诱导后低血压的有效性.
主要方法:
- 系统的文献搜索关于使用胺与替代诱导剂的紧急RSI研究.
- 不管PIH定义如何,包括研究.
- 随机效应模型元分析以确定聚合效应大小.
- 根据比较剂和适应症 (医疗与创伤) 分别对子组进行分析.
主要成果:
- 包括27项研究 (n=31,956),显示出相当大的异质性.
- 基胺与PIH的整体合并几率比率 (OR) 为1.10 (95% CI 0.78-1.56).
- 除了高风险研究外,合并的OR为0.99 (0.69-1.43),表明没有显著差异.
- 在子组中没有发现显著差异,尽管比较胺和埃托米达的趋势出现了 (OR1.38,p=0.058).
结论:
- 在这种紧急RSI研究的大型样本中,胺没有显著影响PIH发病率.
- 这些发现表明,最佳诱导剂的选择可能取决于上下文,需要进一步了解.
- 结果的适用性可能因使用的广泛纳入标准而有所不同.
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