单疗法与组合疗法在重症监护病房激动管理:一个叙事审查
Riseethan Kirishnaventhan1, German Corso2, Suneet Patel1
1Medicine, Saint James School of Medicine, The Quarter, AIA.
Cureus
|December 4, 2025
概括
对重症监护室 (ICU) 动荡的组合疗法可以提供快速控制,但会增加风险. 目前的指导方针建议个性化治疗,而不是常规的联合治疗,以获得更好的患者结果.
科学领域:
- 关键护理医学 关键护理医学
- 神经科学是一个神经科学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 兴奋是一种频繁而复杂的ICU并发症,与妄想,戒断和环境因素有关.
- 它可能会导致不良结果,如长时间的通风和意外的设备移除,可能会增加发病率和死亡率.
- 治疗方案包括单疗法 (二胺或抗精神病药物) 和组合疗法.
研究的目的:
- 审查和比较单一疗法与组合疗法的疗效和安全性,用于ICU中管理激动.
- 评估目前关于ICU激动症治疗策略的证据和指导方针.
主要方法:
- 2000年至2025年间发表的证据的叙述性审查.
- 单疗法 (二,抗精神病药物) 和ICU激动症的组合疗法的比较.
- 分析结果,包括妄想发病率,ICU停留时间和不良事件.
主要成果:
- 二西平对于戒断至关重要,但在广泛使用时,与更高的妄想率和更长的ICU停留时间有关.
- 抗精神病药物很常见,但缺乏一致的证据来改善试验中的妄想结果.
- 组合疗法可以快速控制严重的激动,但会增加过度静止,低血压和长时间机械通风的风险.
结论:
- 目前的重症监护指南,如PADIS建议,不支持常规的ICU动荡组合治疗.
- 治疗决策应优先考虑个性化的患者选择,结构化的镇静方案和仔细的定位.
- 与长期的神经和功能结果平衡即时激动控制是必不可少的.
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