Chest:血管活性药物对机械通气患者ICU获得性衰弱的影响

2018-09-12 xing.T MedSci原创

由此可见,在参加早期活动的随机临床试验的机械通气患者中,血管活性药物的使用与ICU获得性衰弱的发生发展独立相关。进一步评估这种关系的前瞻性试验是很有必要的。

血管活性药物通常用于治疗重症患者,但是它们对ICU获得性衰弱发生的影响尚未得到很好的描述。近日,呼吸领域权威杂志chest上发表了一篇研究文章,该研究的目的是评估血管活性药物使用与ICU获得性衰弱结局之间的关系。

该研究是对参加了早期职业和物理治疗与常规治疗随机临床试验的机械通气患者(N=172)进行的二次分析,该试验评估了出院时ICU获得性衰弱的终点。患者接受了床旁肌肉力量测试,并且由不知道研究分配的治疗师来评估ICU获得性衰弱。研究人员评估了血管活性药物使用对该人群ICU获得性衰弱发生率的影响。

在logistic回归分析中,血管活性药物的使用增加了ICU获得性衰弱的发生几率(比值比[OR]为3.2; P=0.01),与所有其它确定的衰弱风险因素无关。血管活性药物使用的持续时间(以天计)(OR为1.35; P=0.004)和累积的去甲肾上腺素剂量(μg/kg/d)(OR为1.01; P=0.02)(但不是加压素或去氧肾上腺素)也与ICU获得性衰弱的结局独立相关。

由此可见,在参加早期活动的随机临床试验的机械通气患者中,血管活性药物的使用与ICU获得性衰弱的发生发展独立相关。进一步评估这种关系的前瞻性试验是很有必要的。

原始出处:


Krysta S. Wolfe,et al. Impact of Vasoactive Medications on ICU-Acquired Weakness in Mechanically Ventilated Patients.chest.2018.https://doi.org/10.1016/j.chest.2018.07.016

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    2018-10-19 Smile2680
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