评估压力剂量皮质带在败血栓冲击中的压力剂量
Hannah Elizabeth Gilchrist1, Matthew Roginski1, Alyson Esteves1
1Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
Hospital pharmacy
|July 17, 2025
概括
在败血症休克中停止压力剂量皮需要仔细考虑. 紧缩类固醇可能会降低死亡率,但可以增加血管压缩剂的需求和ICU住院.
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.
- 内分泌学 在内分泌学.
背景情况:
- 压力剂量皮是感染性休克的标准治疗方法.
- 长期使用皮需要一个停止使用的策略,以避免戒断.
- 目前的指导方针缺乏针对性冲击中的类固醇缩的具体建议.
研究的目的:
- 检查压力剂量皮在败血症休克患者中逐渐缩小的处方做法.
- 评估皮缩剂对患者结局的影响.
主要方法:
- 对276名患有败血症休克的重症监护病房 (ICU) 患者进行了回顾性评估,这些患者接受了皮质≥24小时.
- 对皮的持续时间,逐渐缩小的方法和持续时间的分析.
- 评估血管压缩率的变化和患者的结果 (死亡率,ICU停留时间,机械通风持续时间).
主要成果:
- 50.4%的患者接受了皮缩剂,平均持续时间为2天.
- 收缩主要涉及降低频率 (56.8%).
- 经过逐渐缩小治疗的患者在医院和ICU死亡率下降,但在ICU停留时间,机械通风持续时间和血管压缩剂率在逐渐缩小治疗开始后24小时增加.
结论:
- 在压力剂量的持续时间,实施和方法方面存在显著的异质性.
- 为了优化以患者为中心的结果,需要进一步的研究和标准化的协议来停止皮的治疗.
相关概念视频
01:11Renal Failure: Dose Adjustments
164
In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
164
01:20Desensitization and Tachyphylaxis
2.2K
Tachyphylaxis is described as a rapid decrease in response to a drug after repeated or continuous administration of the same drug dose. It is a phenomenon where the body becomes less responsive to a particular substance or intervention over time, requiring higher doses or stronger interventions to achieve the same effect. It results from adaptive changes in the body's receptors, signaling pathways, or physiological processes that occur in response to prolonged exposure to a stimulus.
2.2K
01:21Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
204
Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
204
01:01Dosage Regimen: Fixed Dose
2.0K
Fixed-dose regimens are a common approach to administer drugs to achieve and maintain desired levels of the drug in the body. In this dosing strategy, a specific amount of medication is given at regular intervals, often multiple times a day, to ensure a consistent drug concentration in the bloodstream.
Fixed-dose regimens can be used for various routes of administration, including intravenous (IV) injections and oral medications. For IV administration, a predetermined amount of the drug is...
Fixed-dose regimens can be used for various routes of administration, including intravenous (IV) injections and oral medications. For IV administration, a predetermined amount of the drug is...
2.0K
01:24Rational Dosage Regimen: Maintenance Dose and Loading Dose
4.4K
A rational dosage regimen considers a drug's pharmacokinetics, including its absorption, distribution, metabolism, and elimination from the body. By understanding these factors, the appropriate dosage can be determined, and the dosing schedule can be designed to achieve and maintain the desired therapeutic effect while minimizing adverse effects.
In most cases, drugs are administered repetitively or infused continuously to maintain a steady-state concentration in the body. At a steady...
In most cases, drugs are administered repetitively or infused continuously to maintain a steady-state concentration in the body. At a steady...
4.4K
01:37Hypothalamic-Pituitary Axis
61.8K
The response to stress—be it physical or psychological, acute or chronic—involves activation of the Hypothalamic-Pituitary-Adrenal (HPA) axis. The HPA axis is part of the neuroendocrine system because it involves both neuronal and hormonal communication. Its function is to regulate homeostatic systems—metabolic, cardiovascular, and immune—providing the necessary means to respond to a stressor.
61.8K