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危急病患者中与葡萄糖皮质体治疗相关的并发症
Paola Confalonieri1, Nicolò Reccardini1, Stefano Kette1
1Pulmonology Unit, Department of Medical Surgical and Health Sciences, University of Trieste, Hospital of Cattinara, Trieste, Italy.
Seminars in respiratory and critical care medicine
|October 8, 2025
概括
葡萄糖皮质类药物 (GCs) 对患有严重炎症的重症患者提供了显著的益处,改善了通风时间缩短和死亡率等结果. 仔细监测和逐渐减少是管理潜在副作用和最大限度地提高GC治疗的安全性的关键.
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.
- 免疫学 免疫学 免疫学
背景情况:
- 葡萄糖皮质类药物 (GCs) 对于在危急疾病中管理严重的全身炎症至关重要.
- 短期,低至中等剂量的GC使用在败血症,ARDS和肺炎中显示出好处.
- 在危急疾病中,GC的风险益处概况与慢性炎症疾病不同.
研究的目的:
- 综合证据与严重病情的成年人中GC使用相关的并发症.
- 提供基于证据的GC在重症监护中的安全性和有效性的评估.
主要方法:
- 基于证据的综合相关文献.
- 对并发症的审查,包括代谢,感染,肌肉骨,神经精神和胃肠道的影响.
- 分析下丘脑-垂体-上腺轴抑制和逐渐缩小的策略.
主要成果:
- 高血糖是常见的,但过渡性和可控的.
- 随着适当的剂量,鼻腔感染不会显著增加;机会性感染需要保持警.
- 肌肉骨和神经精神疾病的影响往往取决于剂量,是可逆的.
- 抑制HPA轴需要逐渐的逐渐缩小.
结论:
- 在危急疾病中,当精确地使用,仔细监测和逐渐减少时,GC是安全和有效的.
- 综合性策略可以提高GC的疗效,并减少所需剂量.
- 了解并管理并发症优化了GC在重症监护中的治疗潜力.
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