Crit Care:β受体阻滞剂对心源性休克患者正性肌力反应和临床结局的影响

2021-08-11 MedSci原创 MedSci原创

CS发生前24小时内采用BB治疗不会对临床结局或血流动力学参数产生负面影响。相反,BB的使用与早期复苏期的死亡人数减少有关。

心源性休克(CS)与发病率和死亡率相关。β受体阻滞剂(BB)的使用对CS患者的影响仍未明确。

近日,危重病医学领域权威杂志Critical Care上发表了一篇研究文章,研究人员试图评估在CS发生前24小时内接受BB治疗的患者的临床结局和血流动力学反应。


研究人员对参加多巴酚丁胺与米力农比较试验的CS患者进行了分析。该研究的主要结局是全因死亡率、心脏骤停复苏、需要心脏移植或机械循环支持、非致命性心肌梗死、短暂性脑缺血发作或卒中或开始肾脏替代治疗的复合结局。次要结局包括主要复合结局各个组分和来自肺动脉导管的血流动力学反应指标。


在192名参与者中,93名患者(48%)接受了BB治疗。在整个住院期间,BB组47名患者(51%)发生了主要结局,未采用BB治疗组52名患者(53%)发生了主要结局(RR为0.96;95%CI为0.73-1.27;P=0.78)。BB组的早期死亡较少(RR为0.41;95%CI为0.18-0.95;P=0.03)。在整个住院期间,两组主要结局的其他单个组分或血流动力学反应没有差异。
 
由此可见,CS发生前24小时内采用BB治疗不会对临床结局或血流动力学参数产生负面影响。相反,BB的使用与早期复苏期的死亡人数减少有关。

原始出处:

Pietro Di Santo.et al.Impact of baseline beta-blocker use on inotrope response and clinical outcomes in cardiogenic shock: a subgroup analysis of the DOREMI trial.Critical Care.2021.https://ccforum.biomedcentral.com/articles/10.1186/s13054-021-03706-2

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    2022-01-01 zhyy88
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    2021-08-13 mhm295
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    2021-08-12 qingbao2004

    学习了

    0

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