Intens Care Med:固定化多黏菌素B血液灌流与成年脓毒症/感染性休克危重患者死亡率!

2017-12-15 xing.T MedSci原创

由此可见,目前没有足够的证据支持常规使用PMX-HP来治疗脓毒症或脓毒性休克患者。

固定化多粘菌素B血液灌流(PMX-HP)是清除败血症或感染性休克患者循环中内毒素的辅助疗法。先前的试验显示PMX-HP可以改善替代终点。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,研究人员旨在进行证据综合以评估危重症成年脓毒症或感染性休克患者采用PMX-HP治疗的有效性和安全性。

研究人员检索了MEDLINE、EMBASE、Cochrane图书馆、卫生技术评估数据库、CINAHL、“Igaku Chuo Zasshi”、美国国立卫生研究院临床试验注册中心、世界卫生组织国际临床试验注册平台、大学医院医疗信息网络临床试验注册处、检索文章的参考列表以及PMX-HP制造商的出版物。该研究的主要终点是28天全因死亡率、至少有一钟严重不良事件的患者人数以及器官功能障碍评分。研究人员采用GRADE方法确定证据等级。

6项试验(857名参与者,加权平均年龄为62.5岁)被证实符合分析条件。研究人员对以患者为导向的主要结果进行了评估。与PMX-HP相关的28天死亡率的汇集风险比(RR)为1.03[95%可信区间(CI)为0.78-1.36;I2=25%;n=797]。不良事件合并RR为2.17(95%CI为0.68-6.94;I2=0%;n=717)。在PMX-HP治疗后24-72小时内器官功能障碍评分没有显著改变(标准化平均差异为0.26;95%CI为0.64-0.12;I2=78%;n=797)。

由此可见,目前没有足够的证据支持常规使用PMX-HP来治疗脓毒症或脓毒性休克患者。

原始出处:


Tomoko Fujii, et al. Polymyxin B-immobilized hemoperfusion and mortality in critically ill adult patients with sepsis/septic shock: a systematic review with meta-analysis and trial sequential analysis.Intensive Care Medicine.2017. http://icmjournal.esicm.org/journals/abstract.html?v=0&j=134&i=0&a=5004_10.1007_s00134-017-5004-9&doi=

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    2017-12-26 zwjnj2

    好好好好休息休息休息

    0

  7. 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=269868, encodeId=605f2698681a, content=学习学习.了解了解, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Sat Dec 16 14:18:30 CST 2017, time=2017-12-16, status=1, ipAttribution=)]
    2017-12-18 虈亣靌

    学习了受益匪浅

    0

  8. 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  9. 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=269868, encodeId=605f2698681a, content=学习学习.了解了解, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Sat Dec 16 14:18:30 CST 2017, time=2017-12-16, status=1, ipAttribution=)]
    2017-12-17 wzb521zf

    一起学习学习

    0

  10. 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    2017-12-16 1dd8c52fm63(暂无匿称)

    学习学习.了解了解

    0

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