为晚期心力衰竭患者输注硝普钠。

IF 3.5 3区 医学 Q2 PHARMACOLOGY & PHARMACY
Stefano Ghio , Egidio Traversi , Roberto Maestri , Rita Camporotondo , Angelo Caporotondi , Alessandra Caprino , Alessandro Fasolino , Giampaolo Guazzotti , Laura Scelsi , Annalisa Turco , Maria Teresa La Rovere
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引用次数: 0

摘要

目的:晚期心力衰竭(Advanced heart failure,AdvHF)给治疗带来了巨大挑战,尤其是在无法获得机械循环支持或移植选择的情况下,这凸显了循证医学管理方面的空白。本研究旨在评估硝普钠输注(SNP)对增强AdvHF患者全身和肾脏灌注的安全性和有效性,无论是否同时使用肌力支持:我们回顾性分析了2014年10月至2018年9月期间收治的406例AdvHF患者的病历,这些患者接受了至少一周的夜间SNP输注。在 55 例有症状性低血压或外周灌注不足体征的患者中(全身血压差值 结论:结果表明,无论是否同时使用肌力支持,SNP 都是 AdvHF 患者的安全治疗选择,并强调了硝普钠在改善这些晚期患者全身和肾脏灌注方面的潜在疗效。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Sodium nitroprusside infusion in patients with advanced heart failure

Sodium nitroprusside infusion in patients with advanced heart failure

Aims

Advanced heart failure (AdvHF) poses significant treatment challenges, particularly when mechanical circulatory support or transplant options are unavailable, highlighting a gap in evidence-based medical management. The aim of this study was to evaluate the safety and effectiveness of sodium nitroprusside infusion (SNP) for enhancing systemic and renal perfusion in patients with AdvHF, with or without concomitant inotropic support.

Methods and results

We retrospectively analyzed the medical records of 406 patients with AdvHF admitted between October 2014 and September 2018 who received nocturnal SNP infusions for at least one week. In 55 patients with symptomatic hypotension or signs of peripheral hypoperfusion (differential systemic BP < 15 mmHg), continuous dobutamine infusion was added. In a subset of 155 patients who required multiple hospitalizations (median 3), data from the last hospitalization were used. No symptomatic hypotension leading to discontinuation of SNP (mean dose: 0.5 ± 0.1 μg/kg/min) was reported. Patients showed a significant increase in differential systemic blood pressure after infusion (29.2 ± 8.1 to 36.8 ± 11.6 mmHg, p < 0.001) independent of dobutamine use.

Administration of SNP and dobutamine resulted in greater weight loss compared to SNP alone (−5.33 ± 7.02 vs −3.32 ± 4.0 kg, p < 0.003), but it was also associated with a significant increase in creatinine levels compared to SNP alone (+0.24 ± 0.87 vs +0.02 ± 0.43, p = 0.005).

Conclusions

The results show that SNP is a safe therapeutic choice in AdvHF patients with or without concomitant inotropic support and highlight the potential efficacy of nitroprusside in improving systemic and renal perfusion in these advanced patients.

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来源期刊
Vascular pharmacology
Vascular pharmacology 医学-药学
CiteScore
6.60
自引率
2.50%
发文量
153
审稿时长
31 days
期刊介绍: Vascular Pharmacology publishes papers, which contains results of all aspects of biology and pharmacology of the vascular system. Papers are encouraged in basic, translational and clinical aspects of Vascular Biology and Pharmacology, utilizing approaches ranging from molecular biology to integrative physiology. All papers are in English. The Journal publishes review articles which include vascular aspects of thrombosis, inflammation, cell signalling, atherosclerosis, and lipid metabolism.
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