心脏骤停中的肌肉内上腺素:一个系统的审查
Reem Alshaikh1,2,3, Adeel Sheikh4, Courtney Fleming1
1Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St, London, ON N6A 5C1, Canada.
Resuscitation plus
|November 17, 2025
概括
肌内上腺素可以改善心脏骤停的存活率. 一项系统性审查发现,与静脉或骨内途径相比,成年人接受肌内上腺素的生存率和神经结果有所改善,这需要进一步研究.
科学领域:
- 紧急医疗 紧急医疗
- 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:
- 静脉内 (IV) 或骨内 (IO) 上腺素是心脏骤停的标准,改善了存活率.
- 肌肉内注射 (IM) 上腺素目前没有指示,但可能提供更快的管理和更好的患者结果.
研究的目的:
- 系统地审查证据,比较人体和动物心脏骤停中的IM上腺素与IV/IO上腺素.
- 评估心脏骤停期间不同上腺素给药途径的比较有效性和安全性.
主要方法:
- 遵循PRISMA指南的系统审查,注册在PROSPERO.
- 搜索了数据库对IV,IO和IM上腺素在心脏骤停 (成人,儿童,动物) 的研究,直到2025年6月.
- 评估偏差风险 (ROBINS-I,OHAT) 和证据的确定性 (GRADE).
主要成果:
- 包括一个成人观察性研究 (OHCA),五项动物研究和一项叙述性评论.
- 人类研究表明,与IV/IO相比,IM上腺素与改善的生存率 (11.0%与7.0%) 和神经学上有利的生存率 (9.8%与6.2%) 相关联.
- 动物研究的结果与异质的方法产生混合的结果;证据的整体确定性是低的.
结论:
- 有限的研究存在,但一个人体试验表明IM上腺素可以改善心脏骤停的存活率.
- 需要进一步的研究,包括对人类进行随机对照试验,以确认IM上腺素在心脏骤停方面的疗效.
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