乳酸林格溶液的早期使用和心力衰竭重症患者的死亡率:一项回顾性队列研究
Peng-Fei Wang1, Cheng-Jian Guan1, Qian Chen2
1Department of Cardiology, The Second Hospital of Hebei Medical University, No.215 Heping West Road, Shijiazhuang, 050000, China.
European journal of pharmacology
|October 9, 2025
概括
在心力衰竭 (HF) 患者中,早期哺乳期的灵格溶液 (LR) 可能会改善存活率. 这项研究发现,LR的使用与重症肝炎患者的短期和长期死亡率降低有关.
科学领域:
- 临界护理医学 临界护理医学
- 心脏病学 心脏病学
- 液体复苏 复苏 液体复苏 复苏
背景情况:
- 危急心力衰竭 (HF) 患者的有效流体管理是复杂的.
- 乳酸盐被认为是心肌能基质和心脏功能调节器.
- 这项研究调查了早期乳制林格溶液 (LR) 对高风患者结局的影响.
研究的目的:
- 评估早期哺乳期林格溶液 (LR) 给药与急性心力衰竭 (HF) 患者的短期和长期结果之间的关联.
- 评估LR对重症监护室 (ICU) HF患者死亡率的影响.
主要方法:
- 来自MIMIC-IV数据库的12,354名高风患者的回顾性队列研究.
- 患者按早期 (≤24小时) 的LR给药分组.
- 倾向分数匹配 (PSM) 和治疗权重反向概率 (IPTW) 用于控制混变量.
- 住院,28天和1年死亡率是主要结局.
主要成果:
- 早期LR输液给了4,138名患者;8,216人没有接受它.
- 在PSM后,早期LR与显著降低的住院死亡率 (OR,0.66 [95% CI,0.56-0.78]),28天死亡率 (HR,0.74 [95% CI,0.65-0.83]) 和1年死亡率 (HR,0.77 [95% CI,0.70-0.84]) 相联系.
- IPTW的分析证实了这些发现,在子组分析中得到了一致的结果.
结论:
- 早期哺乳期Ringer溶液的使用与心力衰竭的可接受液体治疗的ICU患者的短期和长期死亡率的降低有关.
- 这些观察结果强调了流体组成在高频管理中的潜在重要性.
- 建议进行随机对照试验,以验证这些关联并为临床实践提供信息.
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