■比较去甲肾上腺素和特利加压素与单用去甲肾上腺素治疗感染性休克。
■在这个前景中,随机对照试验,将50例感染性休克患者随机分为两组。第一组接受特利加压素0.02µg/kg/min(固定剂量)输注和去甲肾上腺素0.01µg/kg/min输注的组合,第二组仅接受去甲肾上腺素0.01µg/kg/min输注。滴定两组中去甲肾上腺素的剂量以实现65-70mmHg的目标MAP。收集的数据是维持高于65mmHg的MAP所需的去甲肾上腺素的剂量,尿量,血清乳酸,降钙素原水平,C反应蛋白,序贯器官衰竭评估(SOFA)评分,血管加压药支持的总持续时间,以及不良反应的发生率。
■在12小时时,I组与II组的去甲肾上腺素剂量为0.141±0.067vs0.374±0.096µg/kg/min(p≤0.005)。血清乳酸较低,I组尿量高于II组(p<0.05)。与第二组相比,第一组在12小时内SOFA评分的降低幅度明显更大。与从ICU出院的II组患者相比,I组患者的血管加压药给药时间也显着减少。然而,ICU住院期间两组的死亡率无差异.
■小剂量持续输注特利加压素和去甲肾上腺素有助于实现治疗感染性休克患者的早期复苏目标。
■SahooP,KothariN,GoyalS,夏尔马A,BhatiaPK.去甲肾上腺素和特利加压素与去甲肾上腺素单独治疗感染性休克的比较:一项随机对照研究。印度JCritCareMed2022;26(6):669-675。
UNASSIGNED: To compare norepinephrine and
terlipressin vs norepinephrine alone for management of septic shock.
UNASSIGNED: In this prospective, randomized control
trial, 50 adult patients with septic shock were randomized into two groups. Group I received a combination of injection
terlipressin 0.02 µg/kg/min (fixed dose) infusion and injection norepinephrine 0.01 µg/kg/min infusion and group II received injection norepinephrine 0.01 µg/kg/min infusion alone. Dose of noradrenaline in both the groups was titrated to achieve the target MAP of 65-70 mm Hg. The data collected were the dose of norepinephrine required to maintain an MAP of above 65 mm Hg, urine output, serum lactate, procalcitonin level, C-reactive protein, sequential organ failure assessment (SOFA) score, total duration of vasopressor support, and incidences of the adverse effects.
UNASSIGNED: The norepinephrine dose in group I vs group II at 12 hours was found to be 0.141 ± 0.067 vs 0.374 ± 0.096 µg/kg/min (p ≤0.005). The serum lactate was lower, and urine output was higher in group I than group II (p <0.05). Group I had a significantly greater reduction in SOFA score in 12 hours than group II. Group I patient also had a significant decrease in the duration of vasopressor administration than group II patients being discharged from the ICU. However, there was no difference in the mortality between the two groups during their ICU stay.
UNASSIGNED: A low-dose continuous infusion of terlipressin and norepinephrine could help attain early resuscitation goals for managing patients with septic shock.
UNASSIGNED: Sahoo P, Kothari N, Goyal S, Sharma A, Bhatia PK. Comparison of Norepinephrine and
Terlipressin vs Norepinephrine Alone for Management of Septic Shock: A Randomized Control
Study. Indian J Crit Care Med 2022;26(6):669-675.