s- ketamine和米达佐拉姆对呼吸系统变异性的影响:随机对照试验
Oscar F C van den Bosch1, Johan P A van Lennep2, Ricardo Alvarez-Jimenez1
1Department of Anesthesiology, Amsterdam UMC location Vrije Universiteit, Amsterdam, the Netherlands.
米达佐拉姆显著降低呼吸系统的可变性,影响呼吸系统的适应性. S-ketamine在很大程度上保持了这种可变性,这表明它可能是自发呼吸挑战的患者更安全的镇静选择.
科学领域:
- 麻醉学和重症监护
- 呼吸系统生理学
- 药理学
背景情况:
- 镇静通常使用s-ketamine和midazolam,旨在保持自发呼吸.
- 这些镇静剂对呼吸系统可变性的影响,这是呼吸系统适应性的关键指标,目前尚不完全理解.
研究的目的:
- 在镇静期间研究s- ketamine和midazolam对呼吸速率变化 (VRR) 和潮体积变化 (VTV) 的影响.
- 在试点研究中比较s- ketamine和midazolam对呼吸系统适应性的影响.
主要方法:
- 这是一项随机对照试验,涉及28名参与者接受了盲目注射的s- ketamine,midazolam或盐水.
- 使用生物阻抗测量呼吸速率,VRR和VTV的持续,非侵入性测量.
- 使用线性混合模型分析输注过程中的变化.
主要成果:
- 与盐水相比,米达佐拉姆显著降低了VRR和VTV.
- 虽然S- 胺呈现下降VTV的趋势,但没有显著影响VRR.
- 任何一种药物都没有显著改变平均呼吸速率.
结论:
- 服用米达佐拉姆会减少呼吸系统的可变性,可能会损害呼吸系统的适应性.
- 似乎比米达佐拉姆更有效地保护呼吸系统的可变性.
- 在需要保持自发呼吸的患者中,S-ketamine可能是镇静剂的更安全替代品.
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