血管活性药物的实践变化 跨ICU亚型的心脏性休克的使用:回顾性队列研究
Jackson L Shriver1, David E Hamilton2, Ashley M Hesson3
1University of Michigan, Department of Internal Medicine, Ann Arbor, MI.
medRxiv : the preprint server for health sciences
|August 12, 2025
概括
临床实践的变化,而不仅仅是患者因素,在心脏性休克患者中显著影响了血管活性和内扩散剂治疗的使用. 重症监护室 (ICU) 环境在治疗决策中起着重要作用.
科学领域:
- 关键护理医学 关键护理医学
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 心脏性休克具有显著的发病率和死亡率.
- 血管活性和内扩展剂的管理策略有很大差异.
- 临床实践变化与患者因素对这些疗法的影响尚不清楚.
研究的目的:
- 调查患者层面的变量和临床实践变化的程度如何解释血管活性和内扩散剂治疗对心脏性休克的使用的差异.
- 为了比较不同重症监护室 (ICU) 设置中的内扩散剂药物使用情况.
主要方法:
- 分析了2014-2023年期间在密歇根医学重症监护病房 (ICU) 住院的4,525名心脏性休克患者.
- 在心血管,心血管外科和非心脏ICU中比较血管活性药物和内扩张药物的使用情况.
- 混合效应物流建模,以评估患者级变量和ICU位置对治疗变化的贡献.
主要成果:
- 静脉扩散剂的使用因ICU设置而异,在心脏和心胸外科ICU中最高,在非心脏ICU中最低.
- 心力衰竭等患者因素增加了内扩剂的使用,而年龄较大,男性性别和先前心脏骤停减少了它.
- 密切护理室的位置占透剂使用变异的15.8%,而患者级别变量为6.1%.
结论:
- 血管活性药物用于心脏性休克的变化的很大一部分归因于ICU环境.
- 临床实践的变化,特别是ICU环境,是心脏病性休克中内扩散剂治疗的关键决定因素.
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