德克斯梅托米丁或克隆基镇静与重症患者的普罗波相比:A2B随机临床试验
Timothy S Walsh1, Richard A Parker2, Leanne M Aitken3
1Usher Institute, University of Edinburgh, Edinburgh, Scotland.
德克斯梅托米丁和克洛尼丁镇静剂在危急病患者中没有缩短与普罗波相比的输出时间. 这项研究没有发现镇静策略之间的机械通风持续时间有显著差异.
科学领域:
- 危急护理医学
- 药理学
- 呼吸疗法
背景情况:
- 机械呼吸是重症监护室 (ICU) 的维持生命的疗法.
- 在机械通风过程中,镇静对于患者的舒适性和呼吸器同步至关重要.
- 普罗波是一种常见的镇静剂,但像α-2上腺激动剂这样的替代品正在探索潜在的益处.
研究的目的:
- 为了比较基于德克斯梅托米丁或克隆尼丁的镇静剂与基于普罗波的镇静剂的疗效.
- 为了确定α-2上腺激动剂是否会减少机械通风的持续时间.
- 评估不同镇静策略对ICU患者的输出时间的影响.
主要方法:
- 这是一项实用,开放的随机临床试验,涉及41名英国重症监护室的1404名成年患者.
- 患者在开始机械呼吸后的48小时内接受了普罗波和阿片类药物.
- 干预组接受了德克塞米丁或克罗尼丁,而对照组接受了普罗波,目标Richmond兴奋镇静量级分数为-2至1.
主要成果:
- 与普罗波相比,德克斯梅托米丁和克洛尼丁都没有显著减少成功除的时间.
- 德克斯梅托米丁的平均输出时间为136小时,克洛尼丁为146小时,普罗波为162小时.
- 与普罗波相比,使用德克斯梅托米丁和克洛尼丁观察到更高的激动率和严重的胸.
结论:
- 在机械通风的ICU患者中,德克斯梅托米丁和克洛尼丁在加速输出方面并不优于普罗波.
- 虽然这些药物不会改善输出管时间,但可能会增加激动和胸.
- 进一步的研究可能会探索特定的患者亚组或用于镇静的α- 2上腺激动剂的替代结果.
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