严重病患者的IV二碳酸短缺:一个中断的时间序列分析
Amanda Y Leong1,2,3, Andrea Soo1, Andrew Bond4
1Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Critical care medicine
|August 4, 2025
概括
2017年二碳酸短缺减少了IV二碳酸在患有酸性病症的重症患者的使用. 这没有影响存活率或停留时间,但在严重酸性病亚组中需要进一步研究.
科学领域:
- 关键护理医学 关键护理医学
- 腎臟病學 (nephrology) 是一種醫學.
- 药理学 药理学是指药理学的学科.
背景情况:
- 2017年全球范围内静脉注射 (IV) 碳酸短缺的情况,对治疗患有酸性血症的重症患者提出了挑战.
- 血酸性,血中的过度酸度的情况,通常需要用IV二碳酸治疗.
研究的目的:
- 调查2017年IV二碳酸短缺对严重患有酸性病的成年人治疗模式和临床结果的影响.
- 评估在短缺期间的紧急保护措施是否影响了患者的治疗结果.
主要方法:
- 使用来自加拿大阿尔伯塔省17个成人重症监护病房 (ICU) 的数据进行了中断时间序列分析.
- 该研究包括2015年6月1日至2019年12月31日期间的18865名成年ICU入院患者,重点关注血液pH值<7.3的患者.
- 分段回归分析检查了IV二碳酸使用趋势和患者在短缺期间 (2017年6月8日至10月4日) 之前,期间和之后的患者结局.
主要成果:
- 在短缺后,接受IV二碳酸的患者比例显著下降 (从29.3%降至21.5%).
- 在短缺期间,用二碳酸盐治疗的患者更有可能患有严重的酸血症 (pH ≤7.20).
- 在不接受二碳酸盐的pH≤7.20或晚期功能衰竭的患者中,增加了血管压缩剂和连续置换疗法的使用趋势,但没有观察到ICU停留时间或死亡率的显著变化.
结论:
- 在2017年IV二碳酸短缺期间的紧急保护措施成功地减少了其在重症酸性患者中的使用.
- 减少静脉二碳酸的使用与对存活率或ICU停留时间的不良影响无关.
- 未来的研究应该探索在特定的患者亚组中,特别是那些患有严重酸血和/或严重功能障碍的患者中,对二碳酸的最佳使用.
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