利用血度来优化急性二中毒的体外治疗:一个多中心的回顾性队列研究
Yuewei Ling1,2, Zhengsheng Mao3,4, Chuhan Zhou5
1Department of Emergency Medicine, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.
Clinical toxicology (Philadelphia, Pa.)
|December 8, 2025
概括
血二酸度指导了针对急性中毒的个性化体外治疗. 这种方法提高了二中毒患者的生存率,特别是结合血 perfusion 和连续静脉静脉血过.
科学领域:
- 毒理学 毒理学 毒理学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 关键护理医学 关键护理医学
背景情况:
- 迪卡特中毒在亚洲是一个重大的健康问题.
- 对二中毒的最佳增强消除策略仍未确定.
- 血二酸度是指导治疗的潜在生物标志物.
研究的目的:
- 评估血二酸度在调整急性二酸中毒外体治疗的临床效用.
- 根据初始的二水平,比较不同体外治疗方案的有效性.
主要方法:
- 一项多中心回顾性队列研究,涉及163名急性二中毒患者.
- 患者被分为低 (<100微克/升),中 (100-1,000微克/升) 和高 (≥1,000微克/升) 的血二酸度组.
- 外体治疗包括单独输血或与连续静脉血液过相结合;使用卡普兰-梅尔曲线分析生存率.
主要成果:
- 低度组的所有患者都存活了.
- 在中高度组中,接受体外治疗的人中,生存率为48.9%,而拒绝接受治疗的人的死亡率为100%.
- 联合输血和连续静脉输血过显示,高度组的生存率比单独输血更好.
结论:
- 最初的血二酸度可以指导个性化的体外治疗策略.
- 联合输血和连续静脉静脉输血过似乎在严重的二中毒中更有效.
- 需要进一步的随机试验来确认最佳的体外治疗方案.
相关概念视频
Extracorporeal Removal of Drugs: Hemoperfusion and Hemofiltration
178
Hemoperfusion and hemofiltration are critical techniques in medical treatments to eliminate accumulated drugs, metabolites, and electrolytes from the bloodstream. These methods are particularly vital in cases of accidental poisoning and drug overdose.Hemoperfusion involves passing blood through an adsorbent material to remove unwanted substances. The main adsorbents used in hemoperfusion include activated charcoal and Amberlite resins. Activated charcoal can adsorb both polar and nonpolar...
178
Extracorporeal Removal of Drugs: Peritoneal Dialysis and Hemodialysis
367
Patients with end-stage renal disease (ESRD) or those experiencing drug overdose often require extracorporeal methods to eliminate accumulated drugs and metabolites. Hemoperfusion, hemofiltration, and dialysis are the primary techniques to rapidly remove harmful substances without disrupting the patient's fluid and electrolyte balance. For those with compromised renal function, dosage adjustments of concurrent medications may be necessary during extracorporeal drug removal.Dialysis is a process...
367
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
281
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
281
Acute Kidney Injury IV: Diagnostic Studies and Prevention
244
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
244
Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant
196
In patients with renal disease, dosage adjustments are necessary to maintain therapeutic plasma drug concentrations and prevent toxicity or subtherapeutic exposure. Renal impairment alters drug pharmacokinetics, especially in conditions like uremia, where changes such as prolonged elimination half-life and altered apparent volume of distribution can significantly affect drug disposition. These changes require careful modification of the dosing regimen to achieve the desired clinical...
196
Enhanced Elimination of Poison
842
Poison can be effectively removed from the gastrointestinal (GI) tract through various decontamination procedures.
Antidotes serve a crucial role in counteracting the effects of poison by inhibiting enzymes responsible for producing harmful drug metabolites. In some cases, these toxic metabolites can be neutralized by endogenous cosubstrates, which are maintained at specific concentrations to prevent interaction with cellular macromolecules and subsequent cell death.
Renal excretion is the...
Antidotes serve a crucial role in counteracting the effects of poison by inhibiting enzymes responsible for producing harmful drug metabolites. In some cases, these toxic metabolites can be neutralized by endogenous cosubstrates, which are maintained at specific concentrations to prevent interaction with cellular macromolecules and subsequent cell death.
Renal excretion is the...
842


