Baidu
map

Lancet:注射碳酸氢钠可改善肾损伤患者急性酸血症症状

2018-06-15 zhangfan MedSci原创

研究认为碳酸氢钠可降低急性肾损伤重症患者的急性酸血症死亡风险

急性酸血症在危重症患者中发病率较高,碳酸氢钠注射液是潜在的重度代谢性酸血症治疗手段,近日研究人员就碳酸氢钠注射液对危重患者酸血症的治疗效果进行了考察。

本次III期临床研究在法国26个ICU中心开展,因严重酸血症(pH≤7.20,PaCO 2≤45 mm Hg,碳酸氢钠浓度≤20 mmol/l)的患者参与研究,患者器官衰竭评估得分4以上,动脉乳酸浓度>2 mmol/l,随机接受4.2%的碳酸氢钠静脉注射或对照,碳酸氢钠组患者动脉pH维持在7.30左右,30min中注射量125-250mL,24小时内不超过1L。研究的主要终点是28天死亡或7天内器官衰竭。

389人参与研究,其中对照组194人,碳酸氢钠组195人。对照组138人(71%)以及碳酸氢钠组128人(66%)发生终点事件。Kaplan-Meier分析显示组间28天生存率差异不显著(46 vs 55%)。在急性肾损伤评分2或3分人群中,碳酸氢钠治疗可显著提高28天生存率(63% vs 46%)。碳酸氢钠组代谢性碱中毒、高钠血症和低钙血症发病率增加,未发生威胁生命的不良事件。

研究认为碳酸氢钠可降低急性肾损伤重症患者的急性酸血症死亡风险。

原始出处:


本文系梅斯医学(MedSci)原创编译整理,转载需授权!

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1756277, encodeId=d3c41e56277f5, content=<a href='/topic/show?id=974ae3736a1' target=_blank style='color:#2F92EE;'>#碳酸氢钠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73736, encryptionId=974ae3736a1, topicName=碳酸氢钠)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f79237095664, createdName=wenzhiren, createdTime=Mon Apr 15 04:03:00 CST 2019, time=2019-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1829682, encodeId=f05f182968242, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Tue Dec 04 08:03:00 CST 2018, time=2018-12-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=325401, encodeId=73a4325401a0, content=学习一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Tue Jun 19 19:21:08 CST 2018, time=2018-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1397560, encodeId=82e6139e56074, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eoNX3lUOlDKGBUEPNwZx0nibmdcFyeibnX4WMhUSCU2REpGRWtSmnT2CCs0dA5waxvJknYDxwtYnIcQ/132, createdBy=294e2500218, createdName=ms3046638856685384, createdTime=Sun Jun 17 07:03:00 CST 2018, time=2018-06-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=324555, encodeId=94fd3245550e, content=好文献学习啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=120, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b5a62240667, createdName=张新亮1853311252142e2fm, createdTime=Sat Jun 16 06:37:23 CST 2018, time=2018-06-16, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1756277, encodeId=d3c41e56277f5, content=<a href='/topic/show?id=974ae3736a1' target=_blank style='color:#2F92EE;'>#碳酸氢钠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73736, encryptionId=974ae3736a1, topicName=碳酸氢钠)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f79237095664, createdName=wenzhiren, createdTime=Mon Apr 15 04:03:00 CST 2019, time=2019-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1829682, encodeId=f05f182968242, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Tue Dec 04 08:03:00 CST 2018, time=2018-12-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=325401, encodeId=73a4325401a0, content=学习一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Tue Jun 19 19:21:08 CST 2018, time=2018-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1397560, encodeId=82e6139e56074, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eoNX3lUOlDKGBUEPNwZx0nibmdcFyeibnX4WMhUSCU2REpGRWtSmnT2CCs0dA5waxvJknYDxwtYnIcQ/132, createdBy=294e2500218, createdName=ms3046638856685384, createdTime=Sun Jun 17 07:03:00 CST 2018, time=2018-06-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=324555, encodeId=94fd3245550e, content=好文献学习啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=120, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b5a62240667, createdName=张新亮1853311252142e2fm, createdTime=Sat Jun 16 06:37:23 CST 2018, time=2018-06-16, status=1, ipAttribution=)]
    2018-12-04 howi
  3. [GetPortalCommentsPageByObjectIdResponse(id=1756277, encodeId=d3c41e56277f5, content=<a href='/topic/show?id=974ae3736a1' target=_blank style='color:#2F92EE;'>#碳酸氢钠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73736, encryptionId=974ae3736a1, topicName=碳酸氢钠)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f79237095664, createdName=wenzhiren, createdTime=Mon Apr 15 04:03:00 CST 2019, time=2019-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1829682, encodeId=f05f182968242, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Tue Dec 04 08:03:00 CST 2018, time=2018-12-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=325401, encodeId=73a4325401a0, content=学习一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Tue Jun 19 19:21:08 CST 2018, time=2018-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1397560, encodeId=82e6139e56074, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eoNX3lUOlDKGBUEPNwZx0nibmdcFyeibnX4WMhUSCU2REpGRWtSmnT2CCs0dA5waxvJknYDxwtYnIcQ/132, createdBy=294e2500218, createdName=ms3046638856685384, createdTime=Sun Jun 17 07:03:00 CST 2018, time=2018-06-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=324555, encodeId=94fd3245550e, content=好文献学习啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=120, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b5a62240667, createdName=张新亮1853311252142e2fm, createdTime=Sat Jun 16 06:37:23 CST 2018, time=2018-06-16, status=1, ipAttribution=)]
    2018-06-19 wxl882001

    学习一下

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1756277, encodeId=d3c41e56277f5, content=<a href='/topic/show?id=974ae3736a1' target=_blank style='color:#2F92EE;'>#碳酸氢钠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73736, encryptionId=974ae3736a1, topicName=碳酸氢钠)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f79237095664, createdName=wenzhiren, createdTime=Mon Apr 15 04:03:00 CST 2019, time=2019-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1829682, encodeId=f05f182968242, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Tue Dec 04 08:03:00 CST 2018, time=2018-12-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=325401, encodeId=73a4325401a0, content=学习一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Tue Jun 19 19:21:08 CST 2018, time=2018-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1397560, encodeId=82e6139e56074, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eoNX3lUOlDKGBUEPNwZx0nibmdcFyeibnX4WMhUSCU2REpGRWtSmnT2CCs0dA5waxvJknYDxwtYnIcQ/132, createdBy=294e2500218, createdName=ms3046638856685384, createdTime=Sun Jun 17 07:03:00 CST 2018, time=2018-06-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=324555, encodeId=94fd3245550e, content=好文献学习啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=120, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b5a62240667, createdName=张新亮1853311252142e2fm, createdTime=Sat Jun 16 06:37:23 CST 2018, time=2018-06-16, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1756277, encodeId=d3c41e56277f5, content=<a href='/topic/show?id=974ae3736a1' target=_blank style='color:#2F92EE;'>#碳酸氢钠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73736, encryptionId=974ae3736a1, topicName=碳酸氢钠)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f79237095664, createdName=wenzhiren, createdTime=Mon Apr 15 04:03:00 CST 2019, time=2019-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1829682, encodeId=f05f182968242, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Tue Dec 04 08:03:00 CST 2018, time=2018-12-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=325401, encodeId=73a4325401a0, content=学习一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Tue Jun 19 19:21:08 CST 2018, time=2018-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1397560, encodeId=82e6139e56074, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eoNX3lUOlDKGBUEPNwZx0nibmdcFyeibnX4WMhUSCU2REpGRWtSmnT2CCs0dA5waxvJknYDxwtYnIcQ/132, createdBy=294e2500218, createdName=ms3046638856685384, createdTime=Sun Jun 17 07:03:00 CST 2018, time=2018-06-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=324555, encodeId=94fd3245550e, content=好文献学习啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=120, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b5a62240667, createdName=张新亮1853311252142e2fm, createdTime=Sat Jun 16 06:37:23 CST 2018, time=2018-06-16, status=1, ipAttribution=)]
    2018-06-16 张新亮1853311252142e2fm

    好文献学习啊

    0

相关资讯

Diabetes Obes Metab:碳酸氢钠对1型糖尿病患者尿酸结晶和糖尿病性肾小管病的作用!

总之,口服碳酸氢钠可以使尿中pH值正常,并且降低尿酸晶体,并可以作为一种廉价的、安全的糖尿病患者肾小管保护性干预。

NEJM:碳酸氢钠和乙酰半胱氨酸对造影后AKI的预防效果如何?

由此可见,在进行血管造影高并发症风险的患者中,静脉注射碳酸氢钠相比于静脉注射氯化钠或口服乙酰半胱氨酸相比安慰剂对于预防死亡、需要透析或90天肾功能持续下降或用于预防造影相关的急性肾损伤方面并没有显著的益处。

NEJM:碳酸氢钠和乙酰半胱氨酸皆不能降低造影剂相关肾损伤

造影剂相关急性肾损伤可以引起死亡,促进慢性肾病的进展,需要透析治疗,增加花费。为了预防这个并发症,通常于围手术期静脉给予等渗氯化钠输注。

Baidu
map
Baidu
map
Baidu
map