分布性休克患者血管紧张素和肾素使用的真实世界经验:一项单中心描述性研究。

IF 2.1 4区 医学 Q2 ANESTHESIOLOGY
Andreja Möller Petrun, Mario Gorenjak, Franc Svenšek, Nives Matković Lonzarić, Alenka Strdin Košir, Maja Cvikl Knehtl, Evgenija Homšak, Žiga Kalamar, Giovanni Landoni, Andrej Markota
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引用次数: 0

摘要

目的:评价血管紧张素II(一种新型血管加压素)和肾素在现实生活中的使用情况,肾素可作为内源性血管紧张素II缺乏和疾病严重程度的标志。设计:回顾性观察性单中心队列研究。环境:一所大学医院的四个重症监护室。参与者:在2022年8月至2023年8月期间入院的患有分散性休克、没有积极护理限制、持续使用血管收缩剂(去甲肾上腺素基数≥0.3 mcg/kg/min +加压素)的成年患者。干预措施:没有。测量结果及主要结果:感染性休克(38/42,90.5%)和体外循环后血管截瘫(4/42,9.5%)是分配性休克的原因。血管紧张素II启动后,去甲肾上腺素基础剂量在4、24和48小时分别下降(0.40±0.25 mcg/kg/min、0.21±0.11 mcg/kg/min和0.13±0.06 mcg/kg/min),抗利尿激素剂量下降。肾素浓度由376.90±168.50 mU/L降至188.24±167.47 mU/L (p < 0.01)。对照肾素在幸存者出院时低于非幸存者(幸存者78.06±121.14 mU/L,非幸存者259.07±163.4 mU/L, p < 0.01)。结论:血管紧张素II可用于减少非血管紧张素II血管加压药物的剂量,肾素浓度可能有助于预测分布性休克患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Real-world Experience of Angiotensin II and Renin Usage in Patients With Distributive Shock:A Single-center Descriptive Study.

Objective: To evaluate real-life use of angiotensin II, a novel vasopressor, and renin, which can be used as a marker of endogenous angiotensin II deficiency and disease severity.

Design: A retrospective observational single-center cohort study.

Setting: Four intensive care units in one university hospital.

Participants: Adult patients with distributive shock, no limitations of active care, and with ongoing use of vasoconstrictors (norepinephrine base ≥0.3 mcg/kg/min plus vasopressin), who were admitted between August 2022 and August 2023.

Interventions: None.

Measurements and main results: Septic shock (38/42, 90.5%) and post-cardiopulmonary bypass vasoplegia (4/42, 9.5%) were the causes of distributive shock. After the initiation of angiotensin II, a decrease in the norepinephrine base dose at 4, 24, and 48 hours (0.40 ± 0.25 mcg/kg/min, 0.21 ± 0.11 mcg/kg/min, and 0.13 ± 0.06 mcg/kg/min, respectively), and a decrease in vasopressin dose were observed. Renin concentration decreased after initiation of angiotensin II from 376.90 ± 168.50 mU/L to 188.24 ± 167.47 mU/L (p < 0.01). Control renin was lower in survivors to hospital discharge compared with nonsurvivors (78.06 ± 121.14 mU/L in survivors, v 259.07 ± 163.4 mU/L in nonsurvivors, p < 0.01).

Conclusions: Angiotensin II can be used to decrease the doses of non-angiotensin II vasopressors, and renin concentration may potentially aid in the prognostication of patients with distributive shock.

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来源期刊
CiteScore
4.80
自引率
17.90%
发文量
606
审稿时长
37 days
期刊介绍: The Journal of Cardiothoracic and Vascular Anesthesia is primarily aimed at anesthesiologists who deal with patients undergoing cardiac, thoracic or vascular surgical procedures. JCVA features a multidisciplinary approach, with contributions from cardiac, vascular and thoracic surgeons, cardiologists, and other related specialists. Emphasis is placed on rapid publication of clinically relevant material.
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