Ann Intensive Care:尼古丁替代疗法会否增加ICU患者的不良结局?

2018-07-02 王淳 环球医学

2018年6月,发表在《Ann Intensive Care》的一项随机、对照、双盲的研究,考察了重症监护病房(ICU)中尼古丁替代疗法(NRT)的安全性和有效性。

2018年6月,发表在《Ann Intensive Care》的一项随机、对照、双盲的研究,考察了重症监护病房(ICU)中尼古丁替代疗法(NRT)的安全性和有效性。

背景:评估NRT预防ICU患者尼古丁戒断症状的研究结果存在矛盾。为此,研究人员开展了一项随机、对照、双盲的初步研究,评估NRT在危重患者中的安全性和有效性。

方法:本研究纳入入住2个医学手术重症监护室且入住ICU前每日吸食10只以上香烟的机械通气患者。受试者被随机分配至经皮NRT(14或21 mg/日)或安慰剂,直到离开ICU或30日。吸烟状况通过生物标记物血清可替宁和尿液NNAL证实。主要终点是30天死亡率。在次要终点和析因终点包括90天死亡率/安全性/谵妄、镇静和昏迷的时间及30天时患者结局。

结果:共招募47名患者。NRT和对照组患者的30天死亡率(9.5 vs 7.7%,p=0.84)和90天死亡率(14.3 vs 19.2%,p=0.67)没有差异。两组的严重不良事件是相似的(NRT:4,对照:11,p=0.13)。20天时,NRT患者中无谵妄、镇静和昏迷的平均存活时间是16.6天,相比较,对照组患者是12.6天(p=0.03)。30天时,NRT组离开ICU或医院的患者多于对照组(p=0.03)。

结论:同安慰剂相比,NRT不会影响死亡率或(严重)不良事件的次数。接受NRT的患者20天时无谵妄、镇静和昏迷的存活时间长于对照组患者。未来需要更有力的随机对照试验进一步研究NRT在ICU患者中的安全性和有效性。

试验注册:ClinicalTrials.gov,注册号NCT01362959,注册于2011年6月1日。

原始出处;

Ben de Jong, Anne Sophie Schuppers, Arriette Kruisdijk-Gerritsen, et.al. The safety and efficacy of nicotine replacement therapy in the intensive care unit: a randomised controlled pilot study. Annals of Intensive Care 7 June 2018

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    2018-07-02 1ddf0692m34(暂无匿称)

    学习了.长知识

    0

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