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用于治疗儿童和成人败血症的皮质类固醇
Djillali Annane1, Josef Briegel2, David Granton3
1Department of Critical Care, Hyperbaric Medicine and Home Respiratory Unit, Center for Neuromuscular Diseases; Raymond Poincaré Hospital (AP-HP), Garches, France.
The Cochrane database of systematic reviews
|June 5, 2025
概括
皮质类固醇可能会降低败血症患者的死亡率,并可能缩短住院时间. 然而,关于长期影响和肌肉衰弱等特定危害的证据仍然不确定,需要进一步研究.
科学领域:
- 关键护理医学 关键护理医学
- 药理学 药理学是指药理学的学科.
- 传染性疾病 传染性疾病
背景情况:
- 败血症是一种由感染引起的危及生命的器官功能障碍,可能涉及皮质类固醇代谢问题.
- 皮质类固醇治疗正在被探索为潜在的治疗败血症.
- 这次审查是对2004年以前分析的更新.
研究的目的:
- 评估在儿童和成人败血症患者中使用皮质类固醇的益处和危害.
- 为了比较连续输液与间歇性胆囊注射的皮质类固醇.
主要方法:
- 随机对照试验 (RCT) 的系统审查和元分析.
- 搜索了多个数据库,直到2023年12月,在2024年12月进行了额外的搜索.
- 使用Cochrane RoB 1工具评估偏差风险和使用GRADE的证据确定性.
主要成果:
- 皮质类固醇可能会降低28天和住院死亡率 (中度确定性证据).
- 可能减少重症监护室 (ICU) 和住院时间 (低确定性证据).
- 关于长期死亡率,超级感染和肌肉衰弱的证据确定性低至非常低.
结论:
- 中等确定性证据表明,皮质类固醇可能会降低败血症的死亡率.
- 低确定性证据表明,有可能减少ICU和住院时间.
- 持续与间歇性皮质类固醇的相对有效性和安全性仍然不确定.
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