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盐酸羟苯甲辛用于脓毒性休克儿茶酚胺撤离。

Use of heptaminol hydrochloride for catecholamine weaning in septic shock.

机构信息

Department of Intensive Care, Habib Bourguiba University Hospital, Sfax, Tunisia.

出版信息

Am J Ther. 2012 Jan;19(1):e8-17. doi: 10.1097/MJT.0b013e3181e9b630.

Abstract

We analyze in the current study the impact of heptaminol hydrochloride (Heptamyl) administration in patients with septic shock requiring adrenergic support on the duration of vasopressor infusion and on catecholamine delay weaning. In this prospective study were included 49 nonconsecutive patients with septic shock requiring vasopressor infusion and with stable hemodynamic parameters during more than 24 hours. All these patients were included in a random way to receive or not heptaminol hydrochloride. The primary end point was the effect of heptaminol hydrochloride administration on duration of weaning, defined as cessation of vasopressor support. There were 32 males (65%) and 17 females (35%). The mean age (± standard deviation) was 53.9 ± 22.2 years. Norepinephrine was the most commonly used vasopressor agent (73.4%). The comparison between two groups (with and without heptaminol hydrochloride) showed that two groups had the same epidemiologic, clinical, and biologic findings on intensive care unit admission. In our study, we found that the introduction of Heptamyl was associated with a quick decrease of dose of dopamine and norepinephrine in comparison with the Heptamyl-free group. By comparing the two groups, we found that the delay of catecholamine weaning was significantly faster for the dopamine (P = 0.008) and noradrenalin (P = 0.001) in the Heptamyl group. Finally, the intensive care unit mortality rate and the hospital mortality rate were significantly lower in the Heptamyl group. Our study shows a reduction in norepinephrine and dopamine weaning duration in septic patients enrolled in the heptaminol hydrochloride group.

摘要

我们在当前的研究中分析了盐酸己脒(Heptamyl)在需要肾上腺素支持的脓毒性休克患者中的作用,以评估其对血管加压素输注时间和儿茶酚胺撤药延迟的影响。在这项前瞻性研究中,我们纳入了 49 例连续非连续的需要血管加压素输注且血流动力学参数稳定超过 24 小时的脓毒性休克患者。所有这些患者均以随机方式分为接受或不接受盐酸己脒组。主要终点是盐酸己脒给药对撤药时间的影响,定义为停止血管加压素支持。其中 32 例为男性(65%),17 例为女性(35%)。平均年龄(±标准差)为 53.9 ± 22.2 岁。去甲肾上腺素是最常用的血管加压素药物(73.4%)。两组(有和无盐酸己脒组)比较显示,两组在入住重症监护病房时的流行病学、临床和生物学特征相同。在我们的研究中,我们发现与无盐酸己脒组相比,盐酸己脒的引入与多巴胺和去甲肾上腺素剂量的快速下降相关。通过比较两组,我们发现盐酸己脒组多巴胺(P = 0.008)和去甲肾上腺素(P = 0.001)的儿茶酚胺撤药延迟明显更快。最后,盐酸己脒组的重症监护病房死亡率和医院死亡率显著降低。我们的研究表明,在接受盐酸己脒治疗的脓毒症患者中,去甲肾上腺素和多巴胺的撤药时间缩短。

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