Intens Care Med:肾上腺素与心源性休克患者短期生存的关系!

2018-06-05 xing.T MedSci原创

由此可见,在这个大型队列中,肾上腺素用于CS患者的血流动力学管理会导致死亡风险增加三倍。

儿茶酚胺一直是心源性休克(CS)药物治疗的支柱。最近,有研究报道肾上腺素的使用与有害结局有关。近日,危重病医学领域权威杂志Intensive Care Medicine上发表了一篇研究文章,研究人员的目的是评估所有原因的CS患者肾上腺素的使用与短期死亡率之间的关联。

研究人员对个体数据进行了荟萃分析,并采用预先确定的纳入标准:(1)接受正性肌力药物和/或血管加压素治疗的非手术CS患者、(2)至少有15%的患者单独使用肾上腺素或与其他正性肌力药物/血管加压素联合治疗。该研究的主要结局是短期死亡率。

该分析纳入了十四个发表的队列和两个未发表的数据集。研究人员分析了2583例患者。在所有队列患者中,肾上腺素的使用率为37%(17-76%),短期死亡率为49%(21-69%)。在CS队列中肾上腺素使用百分比与短期死亡率之间呈正相关。与接受其他药物治疗的患者相比,接受肾上腺素治疗的CS患者的死亡风险更高(比值比[CI]=3.3(2.8–3.9))。调整后的死亡率风险在接受肾上腺素治疗的患者中(n=1227)仍然显著(调整后比值比=4.7(3.4-6.4))。倾向评分匹配后,两个338例匹配的患者被确定,肾上腺素的使用仍然对短期死亡率具有强烈的有害影响(比值比=4.2(3-6))。

由此可见,在这个大型队列中,肾上腺素用于CS患者的血流动力学管理会导致死亡风险增加三倍。

原始出处:

Valentine Léopold, et al. Epinephrine and short-term survival in cardiogenic shock: an individual data meta-analysis of 2583 patients.Intensive Care Medicine.2018. http://icmjournal.esicm.org/journals/abstract.html?v=0&j=134&i=0&a=5222_10.1007_s00134-018-5222-9&doi=

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    2018-06-08 马路1平

    是****导致死亡.还是医生依据病人病情程度选择了****时

    0

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    2018-06-07 mhm295
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  8. [GetPortalCommentsPageByObjectIdResponse(id=2038911, encodeId=ee37203891130, content=<a href='/topic/show?id=b45d1e274e8' target=_blank style='color:#2F92EE;'>#TENS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, 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=Sun Mar 17 04:54:00 CST 2019, time=2019-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1895129, encodeId=a92b189512976, content=<a href='/topic/show?id=ce478241e0b' target=_blank style='color:#2F92EE;'>#肾上腺#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82417, encryptionId=ce478241e0b, topicName=肾上腺)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8dba135, createdName=xuyong523, createdTime=Sun Jan 20 10:54:00 CST 2019, time=2019-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=322414, encodeId=e9fa3224141b, content=是****导致死亡.还是医生依据病人病情程度选择了****时, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJlnMA4Mv0JEd3wqGB7GHzs1MsciccMzuKz0NRuK1DznR2t4OvibiaIxQF4BD7icaXxtmRtVzoRjzbSbQ/0, createdBy=11672154424, createdName=马路1平, createdTime=Fri Jun 08 07:31:05 CST 2018, time=2018-06-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1284904, encodeId=d1f3128490462, content=<a href='/topic/show?id=b67d8244123' target=_blank style='color:#2F92EE;'>#肾上腺素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82441, encryptionId=b67d8244123, topicName=肾上腺素)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=325a197, createdName=amyloid, createdTime=Thu Jun 07 10:54:00 CST 2018, time=2018-06-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1332139, encodeId=7693133213944, content=<a href='/topic/show?id=88f9510800b' target=_blank style='color:#2F92EE;'>#心源性休克#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51080, encryptionId=88f9510800b, topicName=心源性休克)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e3fb2500073, createdName=124987cdm26暂无昵称, createdTime=Thu Jun 07 10:54:00 CST 2018, time=2018-06-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1593477, encodeId=3e4215934e79e, content=<a href='/topic/show?id=9850510e9a3' target=_blank style='color:#2F92EE;'>#心源性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51079, encryptionId=9850510e9a3, topicName=心源性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=955718147815, createdName=mhm295, createdTime=Thu Jun 07 10:54:00 CST 2018, time=2018-06-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1608862, encodeId=d223160886245, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Thu Jun 07 10:54:00 CST 2018, time=2018-06-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=321863, encodeId=3c4232186300, content=好文献学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b5a62240667, createdName=张新亮1853311252142e2fm, createdTime=Wed Jun 06 07:33:42 CST 2018, time=2018-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=321715, encodeId=60b7321e159a, content=了解一下.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Tue Jun 05 20:50:43 CST 2018, time=2018-06-05, status=1, ipAttribution=)]
    2018-06-06 张新亮1853311252142e2fm

    好文献学习了

    0

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    2018-06-05 天地飞扬

    了解一下.谢谢分享!

    0

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