Anaesth Intensive Care:全麻下超快速输入铁麦芽糖治疗铁缺乏是安全的

2017-05-13 MedSci MedSci原创

本研究旨在评估全麻期间超快速(15分钟)输入铁麦芽糖对治疗铁缺乏患者的有效性和安全性。研究人员进行了一项前瞻性干预非随机研究,共纳入了99名缺铁有或无贫血表现的成人患者。在超过15分钟的麻醉维持阶段,如果不贫血患者输入500毫克铁麦芽糖,贫血则输入1000毫克。六周评估患者的血流动力学稳定性,立即或延迟铁相关的副作用和疗效。铁麦芽糖输入前中后明显地低血压或血管加压素的需求并无明显差异。术中无严重并

本研究旨在评估全麻期间超快速(15分钟)输入铁麦芽糖对治疗铁缺乏患者的有效性和安全性。

研究人员进行了一项前瞻性干预非随机研究,共纳入了99名缺铁有或无贫血表现的成人患者。在超过15分钟的麻醉维持阶段,如果不贫血患者输入500毫克铁麦芽糖,贫血则输入1000毫克。六周评估患者的血流动力学稳定性,立即或延迟铁相关的副作用和疗效。

铁麦芽糖输入前中后明显地低血压或血管加压素的需求并无明显差异。术中无严重并发症的发生(过敏反应或皮肤染色)。平均(标准差,SD)血红蛋白从术前121(14)g/L上升到六周后131 (12) g/l (P <0.001)。平均(SD)铁蛋白由术前17 (12) μg/l上升至六周后110 (83) μg/l(P <0.001)。六周后随访的64患者中仅有4名(6.25%)铁蛋白<30μg/L。即刻或延迟副作用的发生率与门诊输注铁麦芽糖的患者相似。

总而言之,高达1000毫克的铁麦芽糖可以考虑在15分钟之内输入至全麻患者体内而不会引起明显的血流动力学改变。对于铁缺乏患者铁麦芽糖经此途径治疗似乎是有效的。

原始出处:


Browning RM, Alakeson N, O'Loughlin EJ. Efficacy and safety of ultra rapid iron polymaltose infusion during general anaesthesia. Anaesth Intensive Care. 2017 May;45(3):320-325.

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channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Sun May 14 08:24:58 CST 2017, time=2017-05-14, status=1, ipAttribution=)]
    2017-06-15 AspirantSuo
  5. 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  6. 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  7. 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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Sun May 14 08:40:38 CST 2017, time=2017-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=197887, encodeId=34a019e88784, content=后期的综合反应,应该考察!, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLCxzIqGgHGpnv0v7a7MZQHVVjxvBfHWenpTPmFhDxa6vn3qno88vft2DRqYcyUBQFCRouANp2WgxQ/0, createdBy=b35a44222, createdName=kane35, createdTime=Sun May 14 08:40:18 CST 2017, time=2017-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=197875, encodeId=269c19e875f3, content=非常好的文章,学习了,很受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Sun May 14 08:24:58 CST 2017, time=2017-05-14, status=1, ipAttribution=)]
    2017-05-14 1e1b8538m79(暂无匿称)

    是的,应该有个标准的

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=2038645, encodeId=bae1203864560, content=<a href='/topic/show?id=b45d1e274e8' target=_blank style='color:#2F92EE;'>#TENS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17274, encryptionId=b45d1e274e8, topicName=TENS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3b172500206, createdName=12498ebem19暂无昵称, createdTime=Wed Sep 20 14:13:00 CST 2017, time=2017-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2050689, encodeId=bdad205068980, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, 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level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96556, encryptionId=99ae9655694, topicName=铁缺乏)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=aa5a2500103, createdName=ms920641618706883, createdTime=Mon May 15 14:13:00 CST 2017, time=2017-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=197908, encodeId=a82319e90846, content=是的,应该有个标准的, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=eff51996281, createdName=1e1b8538m79(暂无匿称), createdTime=Sun May 14 08:57:40 CST 2017, time=2017-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=197888, encodeId=11e419e88810, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Sun May 14 08:40:38 CST 2017, time=2017-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=197887, encodeId=34a019e88784, content=后期的综合反应,应该考察!, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLCxzIqGgHGpnv0v7a7MZQHVVjxvBfHWenpTPmFhDxa6vn3qno88vft2DRqYcyUBQFCRouANp2WgxQ/0, createdBy=b35a44222, createdName=kane35, createdTime=Sun May 14 08:40:18 CST 2017, time=2017-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=197875, encodeId=269c19e875f3, content=非常好的文章,学习了,很受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Sun May 14 08:24:58 CST 2017, time=2017-05-14, status=1, ipAttribution=)]
    2017-05-14 龙胆草

    学习了,谢谢分享

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=2038645, encodeId=bae1203864560, content=<a href='/topic/show?id=b45d1e274e8' target=_blank style='color:#2F92EE;'>#TENS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17274, encryptionId=b45d1e274e8, topicName=TENS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3b172500206, createdName=12498ebem19暂无昵称, createdTime=Wed Sep 20 14:13:00 CST 2017, time=2017-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2050689, encodeId=bdad205068980, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, 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level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96556, encryptionId=99ae9655694, topicName=铁缺乏)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=aa5a2500103, createdName=ms920641618706883, createdTime=Mon May 15 14:13:00 CST 2017, time=2017-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=197908, encodeId=a82319e90846, content=是的,应该有个标准的, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=eff51996281, createdName=1e1b8538m79(暂无匿称), createdTime=Sun May 14 08:57:40 CST 2017, time=2017-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=197888, encodeId=11e419e88810, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Sun May 14 08:40:38 CST 2017, time=2017-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=197887, encodeId=34a019e88784, content=后期的综合反应,应该考察!, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLCxzIqGgHGpnv0v7a7MZQHVVjxvBfHWenpTPmFhDxa6vn3qno88vft2DRqYcyUBQFCRouANp2WgxQ/0, createdBy=b35a44222, createdName=kane35, createdTime=Sun May 14 08:40:18 CST 2017, time=2017-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=197875, encodeId=269c19e875f3, content=非常好的文章,学习了,很受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Sun May 14 08:24:58 CST 2017, time=2017-05-14, status=1, ipAttribution=)]
    2017-05-14 kane35

    后期的综合反应,应该考察!

    0

  10. 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channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Sun May 14 08:24:58 CST 2017, time=2017-05-14, status=1, ipAttribution=)]
    2017-05-14 天涯183

    非常好的文章,学习了,很受益

    0

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JAMA:急性缺血性卒中行血栓切除术,选择清醒镇静还是全麻(SIESTA研究)?

由于缺乏来自随机试验的证据,对急性缺血性卒中患者血栓切除术中的最佳镇静和气道管理,仍存在争议。研究目的是,评估对于该类患者,选择清醒镇静,在患者早期神经功能改善方面,是否优于全身麻醉。SIESTA(血管内治疗脑卒中的镇静与插管研究)是一项单中心、随机、平行对照、双盲评估研究,在德国海德堡大学医院进行(2014年4月到2016年2月),包括150例急性前循环缺血性卒中患者,有较高的美国国立卫生研究院

Lancet:婴儿期全麻不会增加神经发育不良的风险

临床前数据表明,全麻药影响大脑发育。来自队列研究的混合证据表明,幼儿接触到麻醉剂增加了神经发育不良结局的风险。该研究的目的是研究婴儿全身麻醉是否对神经发育结果有任何影响。该报告的2岁时常规麻醉神经发育结局的次要终点与脊髓麻醉(GAS)试验进行了比较。在这个国际评估者盲的随机对照等效性试验中,研究人员招募了出生在妊娠超过26孕周且60孕周以下的婴儿,并有腹股沟疝修补术,这些婴儿来自于澳大利亚,意大利

J Neurosurg Anesthesiol:全麻可显著影响苍白球神经元的微电极记录

局部麻醉是进行深部脑刺激器植入的患者最常使用的麻醉技术,在此过程中患者处于有或没有有意识的镇静状态,从而有利于术中微电极记录(MERs)的目标定位。然而,对一些患者来说,特别是肌张力障碍的患者,深部脑刺激器的植入或许需要在全麻下进行。基于此,多伦多大学的研究人员,对肌张力障碍患者在进行DBS植入手术时,全身麻醉对于苍白球神经元微电极记录的影响进行了检测。 在IRB支持下,研究人员对200

Anaesthesia:腰椎手术,全麻还是脊髓麻醉?

通常情况下,腰椎手术需要在全身麻醉下进行,然而有时也会采用脊髓麻醉。本研究旨在系统性回顾和荟萃分析分析对比这两种麻醉方法的研究。 本次荟萃分析仅纳入相关的随机对照试验,并计算血流动力学、失血量、手术时间、镇痛、恶心和/或呕吐以及住院时间的风险比或标准化均差。 最终研究共纳入了8项研究,包括625名患者。结果,与全身麻醉相比,脊髓麻醉的风险比(95% CI)术中高血压的风险比为0.31(

全麻下术中不明原因低钾致室颤1例报告

患者,女,47岁。因“发现左侧颈部包块3+月”以“左腮腺包块”于2012年12月13日入院。心电图(ECG)无异常。血生化:K+3.8mmoI/L。常规术前禁饮禁食后拟全麻下行“左腮腺包块切除术”。患者入室后BP107/68mmHg,HR80次/分,R15次/分,SpO297%,予长托宁0.4mg,咪哇安定2mg,拘椽酸舒芬太尼10μg,顺式阿曲库按10mg,丙泊酚100mg诱导后顺利插管。手术医

Lancet:音乐可以减轻术后患者疼痛和焦虑

音乐是一种无创、安全、便宜的干预措施,可以很简单以及成功的实施。研究者进行了一项系统回顾和荟萃分析评估音乐能都改善术后患者的恢复。该研究纳入了关于中枢神经系统或头部和颈部的手术,干预措施包括任何形式的术前、术中、术后音乐干预,与标准的日常照顾或非药物干预比较。最终有73篇RCTs纳入系统回顾,各研究样本大小在20-458之间,音量类型、定时、持续时间等也不同,对照组包括常规护理、没有音乐的耳机、白