Department of Emergency Medicine, Inha University School of Medicine, Incheon, Republic of Korea.
Department of Biomedical Sciences, Inha University School of Medicine, Incheon, Republic of Korea.
Am J Emerg Med. 2018 Jun;36(6):935-941. doi: 10.1016/j.ajem.2017.10.054. Epub 2017 Oct 31.
Clinical studies have indicated that transient hypotension can occur after propacetamol administration. This study aimed to analyze the hemodynamic changes after propacetamol administration in patients visiting the ED due to febrile UTI. We also examined the incidence of propacetamol-induced hypotension and compared the clinical characteristics of patients with persistent hypotension, defined as requiring additional fluids or vasopressors, to those with transient hypotension.
A retrospective analysis of the electronic medical records of patients who visited the ED between June 2015 and May 2016, were diagnosed with febrile UTI, and treated with propacetamol, was conducted.
We included 195 patients in this study; of these, 87 (44.6%) showed hypotension. In all patients, significant decreases in systolic blood pressure (SBP; 135.06±20.45mmHg vs 117.70±16.41mmHg), diastolic blood pressure (DBP; 79.74±12.17mmHg vs 69.69±10.96mmHg), and heart rate (97.46±17.14mmHg vs 90.72±14.90mmHg) were observed after propacetamol administration. The basal SBP and DBP were higher in the hypotension than in the non-hypotension group (basal SBP: 144.4±22.3mmHg vs 127.6±15.3mmHg; basal DBP: 83.3±12.6mmHg vs 76.9±11.0mmHg). Patients with persistent hypotension had a lower baseline BP, which was not elevated despite fever, and a higher rate of bacteremia than those with transient hypotension.
Although febrile UTI patients treated with propacetamol in the ED showed hemodynamic changes, these changes did not have a large effect on their prognosis. However, in patients who showed bacteremia or a normal initial BP despite fever, the possibility of developing persistent hypotension should be considered.
临床研究表明，丙帕他莫给药后可能会出现短暂性低血压。本研究旨在分析因发热性尿路感染（UTI）就诊于急诊科的患者使用丙帕他莫后的血流动力学变化。我们还检查了丙帕他莫引起的低血压的发生率，并比较了持续低血压（定义为需要额外补液或血管加压药）患者和短暂性低血压患者的临床特征。
对 2015 年 6 月至 2016 年 5 月期间因发热性 UTI 就诊于急诊科并接受丙帕他莫治疗的患者的电子病历进行回顾性分析。
本研究共纳入 195 例患者；其中 87 例（44.6%）出现低血压。所有患者的收缩压（SBP；135.06±20.45mmHg 比 117.70±16.41mmHg）、舒张压（DBP；79.74±12.17mmHg 比 69.69±10.96mmHg）和心率（97.46±17.14mmHg 比 90.72±14.90mmHg）在丙帕他莫给药后均显著下降。低血压组的基础 SBP 和 DBP 高于非低血压组（基础 SBP：144.4±22.3mmHg 比 127.6±15.3mmHg；基础 DBP：83.3±12.6mmHg 比 76.9±11.0mmHg）。持续性低血压患者的基础血压较低，即使发热也未升高，且菌血症发生率高于短暂性低血压患者。
尽管急诊科使用丙帕他莫治疗的发热性 UTI 患者出现血流动力学变化，但这些变化对其预后影响不大。然而，对于发热时仍表现出菌血症或正常初始血压的患者，应考虑持续性低血压的可能性。
