对患者重要的上胃肠道出血的危险因素
Adam M Deane1,2,3, François Lauzier4, Neill K J Adhikari5
1The University of Melbourne, Centre for Integrated Critical Care , Melbourne, Victoria, Australia.
在入侵通风的成年人中,患者重要的上部胃肠道出血的危险因素包括较高的疾病严重程度,血管抑制剂和血小板抑制剂. 潘托普拉和肠道营养显著降低了出血风险.
科学领域:
- 关键护理医学 关键护理医学
- 胃肠病学 胃肠病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 患者重要的胃肠道出血是侵入性通风患者的关键结果.
- 这种特定出血事件的危险因素在很大程度上是未知的.
- 了解这些因素对于制定有针对性的预防策略至关重要.
研究的目的:
- 识别和分析与患者重要的上胃肠道出血相关的风险因素,在需要侵入性通风的成年人中.
- 为改善重症监护病房患者安全和临床决策提供数据.
主要方法:
- 在国际试验数据库上进行了预先计划的回归分析.
- 在前3天内评估了基线和时间变化的风险因素.
- 考虑到疾病严重程度 (APACHE II分数) 和相应的死亡风险.
主要成果:
- 在4821名患者中,2.7%的患者出现了患者重要的上部胃肠道出血.
- 风险增加与较高的APACHE II分数,血管压缩剂使用,严重的血小板缩和血小板抑制剂有关.
- 松托普拉的使用 (HR 0.36) 和肠道营养 (HR 0.81 每500毫升/天) 与显著降低出血风险有关.
结论:
- 几种因素显著影响了侵入性通风期间患者重要的上部胃肠道出血的风险.
- 潘托普拉证明了独立于肠道营养量的保护作用.
- 肠道营养也显示出与出血风险的保护性关联.
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