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Intensive Care Med:ICU中积极控制体温的降温效果更好

2020-07-26 MedSci原创 MedSci原创

目前尚不清楚以系统预防和治疗发热为目标的方案是否能在重症监护室(ICU)患者中实现比常规护理更低的平均体温。随机评价积极控制体温与常规体温管理试验的目的是确认这种方案的可行性,以期进行更大规模的试验。

目前尚不清楚以系统预防和治疗发热为目标的方案是否能在重症监护室(ICU)患者中实现比常规护理更低的平均体温。随机评价积极控制体温与常规体温管理试验的目的是确认这种方案的可行性,以期进行更大规模的试验。

 

我们将184名无急性脑部病变的成年人随机分配到系统预防和治疗发热或常规护理中,这些成年人在前12 h内发热。主要结果是随机化后7天内ICU的平均体温。次要结果包括院内死亡率、无ICU天数和出院时删减的生存时间。

 

结果显示,与常规体温管理相比,积极的管理能显著降低平均体温。在两组中,发热一般在72 h内消退,组间平均体温差异在前48 h内最大,此时一般在0.5 ℃左右。总的来说,在89名分配到积极管理的患者中,有23名(25.8%)和89名分配到常规管理的患者中,有23名(25.8%)在医院死亡(OR 1.0,95%CI 0.51-1.96,P = 1.0)。组间无ICU天数或存活至第90天无统计学意义的差异。

 

总之,该研究结果表明,与常规护理相比,积极的体温管理降低了体温;然而,即使在常规护理的患者中,发热也可迅速消退。

 

原始出处:

 

Paul J YoungMichael J Bailey, et al., Randomised evaluation of active control of temperature versus ordinary temperature management (REACTOR) trial. Intensive Care Med. 2019 Oct;45(10):1382-1391. doi: 10.1007/s00134-019-05729-4. 

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  1. [GetPortalCommentsPageByObjectIdResponse(id=1075605, encodeId=5b5610e560500, content=就是说两种方法,积极降的快一些,但不积极也都会降的。, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=90976157158, createdName=ms9000001737836443, createdTime=Tue Nov 30 22:38:35 CST 2021, time=2021-11-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2039207, encodeId=ea85203920e7f, content=<a href='/topic/show?id=b45d1e274e8' target=_blank style='color:#2F92EE;'>#TENS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17274, encryptionId=b45d1e274e8, topicName=TENS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3b172500206, createdName=12498ebem19暂无昵称, createdTime=Sat Mar 13 13:07:45 CST 2021, time=2021-03-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1610589, encodeId=33421610589c8, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Tue Jul 28 08:07:45 CST 2020, time=2020-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1047124, encodeId=34b9104e12459, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Sun Jul 26 20:07:45 CST 2020, time=2020-07-26, status=1, ipAttribution=)]
    2021-11-30 ms9000001737836443

    就是说两种方法,积极降的快一些,但不积极也都会降的。

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1075605, encodeId=5b5610e560500, content=就是说两种方法,积极降的快一些,但不积极也都会降的。, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=90976157158, createdName=ms9000001737836443, createdTime=Tue Nov 30 22:38:35 CST 2021, time=2021-11-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2039207, encodeId=ea85203920e7f, content=<a href='/topic/show?id=b45d1e274e8' target=_blank style='color:#2F92EE;'>#TENS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17274, encryptionId=b45d1e274e8, topicName=TENS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3b172500206, createdName=12498ebem19暂无昵称, createdTime=Sat Mar 13 13:07:45 CST 2021, time=2021-03-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1610589, encodeId=33421610589c8, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Tue Jul 28 08:07:45 CST 2020, time=2020-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1047124, encodeId=34b9104e12459, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Sun Jul 26 20:07:45 CST 2020, time=2020-07-26, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1075605, encodeId=5b5610e560500, content=就是说两种方法,积极降的快一些,但不积极也都会降的。, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=90976157158, createdName=ms9000001737836443, createdTime=Tue Nov 30 22:38:35 CST 2021, time=2021-11-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2039207, encodeId=ea85203920e7f, content=<a href='/topic/show?id=b45d1e274e8' target=_blank style='color:#2F92EE;'>#TENS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17274, encryptionId=b45d1e274e8, topicName=TENS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3b172500206, createdName=12498ebem19暂无昵称, createdTime=Sat Mar 13 13:07:45 CST 2021, time=2021-03-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1610589, encodeId=33421610589c8, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Tue Jul 28 08:07:45 CST 2020, time=2020-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1047124, encodeId=34b9104e12459, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Sun Jul 26 20:07:45 CST 2020, time=2020-07-26, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=1075605, encodeId=5b5610e560500, content=就是说两种方法,积极降的快一些,但不积极也都会降的。, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=90976157158, createdName=ms9000001737836443, createdTime=Tue Nov 30 22:38:35 CST 2021, time=2021-11-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2039207, encodeId=ea85203920e7f, content=<a href='/topic/show?id=b45d1e274e8' target=_blank style='color:#2F92EE;'>#TENS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17274, encryptionId=b45d1e274e8, topicName=TENS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3b172500206, createdName=12498ebem19暂无昵称, createdTime=Sat Mar 13 13:07:45 CST 2021, time=2021-03-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1610589, encodeId=33421610589c8, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Tue Jul 28 08:07:45 CST 2020, time=2020-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1047124, encodeId=34b9104e12459, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Sun Jul 26 20:07:45 CST 2020, time=2020-07-26, status=1, ipAttribution=)]
    2020-07-26 CHANGE

    疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的

    0

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