REACT SHOCK试验协议和分析计划 - - 一项多中心随机对照试验,比较重症患者中个性化血压目标与标准血压目标
Rakshit Panwar1,2, Alison Gibberd3,4, Chris Oldmeadow5,3
1Intensive Care Unit, John Hunter Hospital, Newcastle, Australia. rakshit.panwar@health.nsw.gov.au.
Trials
|October 15, 2025
概括
这项研究调查了个性化血压目标是否能改善严重病情的休克患者的治疗结果. 该REACT SHOCK RCT将定制的平均动脉压目标与标准护理进行比较,旨在降低死亡率.
科学领域:
- 关键护理医学 关键护理医学
- 心血管生理学心血管生理学
- 临床试验方法论 临床试验方法论
背景情况:
- 危急病患者在血管压缩剂治疗期间经常经历相对低血压.
- 目前的管理通常使用标准的平均动脉压 (MAP) 目标,可能会忽视个体患者的需求.
- 根据疾病前的血压来个性化血压目标的好处仍然不确定.
研究的目的:
- 为了确定个性化血压目标策略是否与标准护理相比,改善了严重病情的休克患者的临床结果.
- 评估调整MAP目标与患者疾病前血压水平的有效性.
- 为优化重症监护病房 (ICU) 中的冲击管理提供证据.
主要方法:
- REACT SHOCK RCT是一项国际,多中心,随机对照试验,涉及1260名接受血管压缩剂的非出血性休克患者.
- 患者被分配到一个个性化的MAP目标 (基于最近的疾病前读数,55-95 mmHg) 或标准护理 (默认MAP目标65 mmHg).
- 主要终点是全因14天死亡率,次要终点包括损伤,90天死亡率和需要替代疗法.
主要成果:
- 本节不适用,因为该研究正在进行中,结果尚未提供.
- 该研究旨在提供关于主要和次要终点的最终数据.
- 预计招聘工作将于2028年完成.
结论:
- REACT SHOCK RCT是第一个国际多中心试验,用于评估休克患者个性化血压目标.
- 预计结果将为管理重症患者的平均动脉压的临床实践指南提供信息.
- 研究方案和统计分析计划已经预先确定.
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