Department of Critical Care, Royal Surrey Hospital, Guildford, UK.
SPACeR Group (Surrey Peri-Operative, Anaesthesia and Critical Care Collaborative Research Group), Royal Surrey Hospital, Guildford, UK.
Blood Purif. 2022;51(12):990-996. doi: 10.1159/000523761. Epub 2022 Apr 29.
The potential for treatment of the critically ill using blood purification techniques has been discussed for several decades. However, since the first attempts at applying extracorporeal techniques to patients with sepsis were described, there has been considerable hesitancy towards the widespread adoption of such methods, given the lack of mortality benefit observed and indeed the paucity of randomized controlled studies. However, this is not unique so far as studies on the critically ill are concerned where there is a dearth of studies providing a positive finding to influence clinical practice. Consequently, as well as targeted patient selection, it is perhaps time to consider endpoints other than mortality in studies on the critically ill, particularly in blood purification studies where, to-date, such heterogeneous groups of patients have been studied.
几十年来，人们一直在探讨使用血液净化技术治疗危重症患者的可能性。然而，自首次尝试将体外技术应用于败血症患者以来，由于缺乏观察到的死亡率获益，甚至缺乏随机对照研究，人们对广泛采用此类方法一直持相当大的犹豫态度。然而，就危重症患者的研究而言，这并不是独一无二的，因为缺乏提供积极发现以影响临床实践的研究。因此，除了有针对性的患者选择外，也许是时候考虑除死亡率以外的终点来研究危重症患者了，特别是在血液净化研究中，迄今为止，这些研究中都包括了如此异质的患者群体。
