在重症监护病房中用皮质的剂量频率:两种治疗方案的比较
Abigail Danos1,2, Alyssa Lear3, Erin Roach4
1Atrium Health Carolinas Medical Center, Charlotte, NC, USA.
与标准的50毫克每6小时治疗方案相比,替代性用皮 (100毫克每12小时) 的治疗对败血症休克患者的临床结果类似. 这种败血性休克治疗策略需要进一步研究.
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.
- 临床结果研究研究
背景情况:
- 建议静脉注射 (IV) 皮松用于持续需要血管压缩剂的败血症休克患者.
- 目前的指导方针建议每天200毫克 (连续输注或每6小时50毫克).
- 实施了100毫克每12小时的替代方案,以减少在短缺期间的浪费和成本.
研究的目的:
- 在败血症休克患者中,每12小时输入100毫克皮的临床结果与每6小时输入50毫克的临床结果进行比较.
- 评估不同皮剂量频率对冲击逆转和其他关键指标的影响.
主要方法:
- 对成人败血性休克患者进行了回顾性多中心研究,这些患者需要血管压缩剂和皮24小时以上.
- 包括被诊断患有败血症,严重败血症或败血性休克 (ICD-10代码) 的患者.
- 主要结局:时间到冲击逆转. 二次结果:死亡率,住院时间 (医院/ICU),高血糖.
主要成果:
- 在12小时 (56小时) 和6小时 (65小时) 剂量组 (P=0.21) 之间,震荡逆转的中位时间没有显著差异.
- 住院死亡率是可以比较的 (45.6%对51.9%,P=0.51).
- 在住院/ICU长度或高血糖发生率方面没有观察到差异.
结论:
- 替代的皮松剂量方案 (100每12小时一毫克) 与标准方案 (50每6小时一毫克) 的临床结果相似.
- 这种剂量策略可能是一个可行的选择来管理败血症休克,特别是在药物短缺期间.
- 建议在大型前性研究中进一步验证.
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