在ICU中使用黑色素:系统性审查和元分析
Brian Hao Yuan Tang1, Judith Manalo2, Saifur R Chowdhury3
1Department of Medicine, McMaster University, Hamilton, ON, Canada.
Critical care medicine
|July 15, 2025
概括
补充黑色素可以改善睡眠和减少危急病患者的妄想,而不会增加不良事件. 需要进一步的研究来优化其在重症监护室 (ICU) 的使用.
科学领域:
- 关键护理医学 关键护理医学
- 睡眠医学 睡眠医学
- 药理学 药理学是指药理学的学科.
背景情况:
- 黑色素调节昼夜节律和免疫功能.
- 危急病患者经常经历乱的黑激素水平.
- 外源性黑激素可能提供治疗效益.
研究的目的:
- 系统地审查和元分析临床试验 (RCT) 随机对外源性黑激素补充在严重病情的成年人.
- 评估黑激素对ICU中以患者为中心的结局的影响.
主要方法:
- 搜索了五个电子数据库的相关RCT.
- 包括32个RCT,包括3895名患者,将黑色素与安慰剂进行比较.
- 使用随机效应模型分析数据,并通过GRADE评估证据确定性.
主要成果:
- 黑色素可以减少妄想 (低确定性证据).
- 黑素可能会略微减少ICU停留时间 (低确定性证据).
- 黑素可以改善睡眠质量 (低确定性证据) 和减少不良事件 (低确定性证据).
结论:
- 在重症患者中服用黑素显示出改善睡眠和减少妄想的可能性.
- 证据确定性受到偏见和不一致性的限制.
- 未来的研究应该专注于最佳剂量,时间和特定患者群体.
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