Cistanche puas tuaj yeem pab qhov mob raum mob hnyav?

Teb rau "Puas yog cov kua dej resuscitation "Keyser Soze" ntawm mob raum raug mob hauv cov neeg mob raug mob?

Hu rau:joanna.jia@wecistanche.com/ WhatsApp: 008618081934791

AnatoleHarrois¹*, BenjaminSoyer¹, TobiasGaus², SophieHamada¹, MathieuRaux³, JacquesDuranteau¹ thiab rau pawg Traumabase® Saib tsab ntawv txheeb los ntawm Jamme thiab Salem.

Ntsiab lus:cistanche, mob raum raug mob, cov neeg mob raug mob,dej resuscitation.

Peb txaus siab rau qhov kev txaus siab qhia los ntawm Dr. Jamme thiab Ben Hadj Salem hauv peb txoj kev tshawb fawb tsis ntev los no tau tshaj tawm hauv kev saib xyuas tseem ceeb tshaj tawm txog qhov muaj ntau thiab muaj feem cuam tshuam ntawmmob raum raug mobnyob rau hauv ib tug multicentre pawg ntawm 3111raug mobcov neeg mob[1]. Qhov teeb meem lawv tau tsa yog qhov tsis muaj cov ntaub ntawv ntawm cov kua dej resuscitation, tshwj xeeb tshaj yog hais txog cov crystalloids thiab colloids. Peb qhia rau cov kws sau ntawv pom tias kev xaiv cov kua dej yog qhov teeb meem tseem ceeb los tiv thaivmob hnyavraumraug mobhauvraug mobcov neeg mob. Tseeb tiag, kev tshawb fawb tsis ntev los no tau nug txog kev nyab xeeb ntawm colloids [2] hauvraug mob cov neeg mobnrog rau kev nyab xeeb ntawm NaCl 0.9 feem pua ​​​​hauv ICU cov neeg mob [3]. Peb cov ntaub ntawv khaws cia muab cov ntaub ntawv ntawm kev kho dej ua ntej tsev kho mob rau tag nrho cov kev tshawb fawb cohort nrog rau cov ntaub ntawv ntawm 24-h dej resuscitation rau cov neeg mob hemorrhagic shock (n=355, 11%) ).

Txawm li cas los xij,cistanchetuaj yeem txhim kholub raum ua haujlwmsthiab cov txiaj ntsig raumob raum raug mobthiabraum tsis ua haujlwm

Kaum cuaj feem pua ​​​​ntawm 3111 txoj kev tshawb fawb cov neeg mob tau txais colloids (qhov nruab nrab ntim ntawm 500 mL [IQR 500–750]) thaum 94 feem pua ​​​​ntawm 3111 txoj kev tshawb fawb cov neeg mob tau txais crystalloids (qhov nruab nrab ntim ntawm 500 mL [IQR 500–1000]) thaum lub sij hawm prehospital. Thaum lub ntim ntawm colloids los yog crystalloids tswj nyob rau hauv prehospital chaw raug yuam mus rau hauv tus qauv kev kwv yees ntawmmob hnyavraumraug mob(tag nrho cov theem ntawm RIFLE kev faib tawm), qhov sib txawv ntawm qhov sib txawv tau raws li (ib 1000 mL ntawm kev daws) 1.34 (CI 0.85–2.12, p=0.21) thiab

1.11 (CI 0.84–1.45, p=0.47). Yog li, prehospital kua resuscitation tsis muab nqi ntxiv rau kev kwv yees ntxovmob hnyavraumraug mob. Lub sij hawm ntev ntawm kev kis yuav tsim nyog xav txog txhawm rau txhawm rau txhawm rau muaj peev xwm nephrotoxic nyhuv ntawm cov kua dejlub raum ua haujlwm; Txawm li cas los xij, raws li peb lub hom phiaj tseem ceeb yog kev kwv yees thaum ntxovmob hnyavraumraug mobtom qab raug mob, peb ntseeg tias nws yuav ua rau tus qauv tsis cuam tshuam.

Yim caum xya feem pua ​​​​ntawm cov neeg mob hemorrhagic poob siab tau txais colloids thawj 24 teev ntawm kev saib xyuas (qhov nruab nrab ntim ntawm 1000 mL [IQR 500–2000]). Txawm hais tias tsuas yog 9.6 feem pua ​​​​ntawm lawv tau txais koob tshuaj ntau dua 33 mL / kg, peb tsis tuaj yeem txiav txim siab tias colloids tshwm sim.lub raumtoxicity nyob rau hauv peb kev kawm cohort. Lub sijhawm no, cov neeg mob tau txais qhov nruab nrab ntawm 3500 mL [IQR 2000–6000] ntawm crystalloids. Peb cov ntaub ntawv tsis paub qhov txawv ntawm ntau hom crystalloids thiab tsis muaj cov ntaub ntawv ntawm hyperchloremia los ntsuas qhov ntsuas tsis ncaj ntawm NaCl 0.9 feem pua. Txawm li cas los xij, thaum lub sijhawm kawm, peb lub chaw tau siv, tab sis tsis yog tshwj xeeb, NaCl 0.9 feem pua ​​​​rau cov kua dej resuscitation. Muab ntau npaum li cas ntawm cov tshuaj crystalloids hauv cov neeg mob hemorrhagic shock, peb tsis tuaj yeem tshem tawm cov kua dej uas muaj chloride ntau zuj zus.lub raumkev ua phem.

Lub ntsiab lus tseem ceeb yog kev txhim kholub raum ua haujlwmthiab pabmob raum raug mob

Raws li pom hauv daim duab 1, kev siv colloid tau poob qis hauv ob peb xyoos dhau los thaum crystalloids tseem yog lub hauv paus rau cov kua dej resuscitation hauvraug mobcov neeg mob. Txhawm rau tiv thaiv nephrotoxicity cuam tshuam nrog NaCl 0.9 feem pua, isotonic-balanced crystalloids tau thov kom rov ua kom cov kua dej, suav nrog rau cov neeg mob uas raug mob hlwb [4]. Txawm li cas los xij, cov kev tshawb fawb ntxiv yog tsim nyog los ntsuas seb qhov kev xyaum no txhais tau li cas rau cov txiaj ntsig zoo duaraug mobcov neeg mob. Peb tab tom yuav pib qhov kev tshawb fawb no (NCT03630224).

Kev lees paub

Kev koom tes sau npe ntawm pawg TRAUMABASE: Catherine Paugam Burtz, MD, PhD (Université Denis Diderot thiab Beaujon University Tsev Kho Mob, Hôpitaux Universitaires Paris Nord-Val-De-Seine, Clichy, AP-HP, Fabkis); Romain Pirracchio, MD, PhD (Université Paris Descartes thiab Department of Anaesthesiology thiab Critical Care, Hôpital Européen Georges Pompidou, APPHP, Paris, Fabkis); Anne Godier, MD, PhD (Université Paris Descartes thiab Department of Anaesthesiology thiab Critical Care, Hôpital Européen Georges Pompidou, APHP, Paris, Fabkis); Sylvain Ausset, MD (Anaesthesiology thiab Critical Care, Hôpital d'instruction des armées Percy, Clamart, Fabkis); Eric Meaudre, MD (Department of Anesthesiology and Intensive Care, Military Hospital, Hôpital d'Instruction des Armées Sainte-Anne); Thomas Geeraerts, MD, PhD (Department of Anesthesia thiab Critical Care, University Hospital of Toulouse, University Toulouse 3-Paul Sabatier, Toulouse, France); Nathalie Delhaye, Sorbonne Université, AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Département d'Anesthésie Réanimation, Paris, Fabkis ; Bernard Vigué, Université paris Sud, Université Paris Saclay, Department of Anesthesiology thiab Critical Care, Assistance Publique-Hôpitaux de Paris (AP HP), Bicêtre Hôpitaux Universitaires Paris Sud, Le Kremlin Bicêtre, Fabkis.

Cistanchetuaj yeem zammob raum raug mob.

Nyiaj txiag

Tsis muaj peev txheej nyiaj txiag

Muaj cov ntaub ntawv thiab cov ntaub ntawv

Cov ntaub ntawv siv thiab/lossis tshuaj xyuas thaum lub sijhawm kawm tam sim no muaj los ntawm tus kws sau ntawv raws li kev thov tsim nyog

Cov neeg sau ntawv pab txhawb

AH, thiab JD tau pab txhawb rau txoj kev tshawb fawb lub tswv yim thiab tsim qauv. AH, BS, SH, MR, thiab TG pab txhawb nqa cov ntaub ntawv. AH, SH, BS, thiab JD tau pab txhawb rau kev txheeb xyuas cov ntaub ntawv. AH, BS, SH, MR, TG, thiab JD tau pab txhais cov ntaub ntawv. AH, BS thiab JD tau pab txhawb rau kev sau ntawv. AH, BS, SH, MR, TG, thiab JD tau pab txhawb rau kev hloov kho tseem ceeb. Txhua tus kws sau ntawv tau nyeem thiab pom zoo cov ntawv sau kawg.

Kev pom zoo ntawm kev ncaj ncees thiab kev tso cai los koom

CovKev raug mobPab pawg Base® tau txais kev pom zoo rau txoj kev tshawb fawb no, suav nrog kev zam kev pom zoo los ntawm Pawg Saib Xyuas Kev Tshawb Fawb (Comité pour la Protection des Personnes, Paris VI-Pitié-Salpêtrière, Fabkis). Cov ntaub ntawv tau pom zoo los ntawm Pawg Neeg Saib Xyuas Kev Tshawb Fawb Txog Kev Tshawb Fawb Txog Kev Noj Qab Haus Huv (Comité Consultatif sur le Traitement de l'Information en matière de Recherche dans le Domaine de la Santé), thiab Fabkis National Commission on Computing thiab Liberty (Commission Nationale Informatique et Liberté).

Tso cai rau kev tshaj tawm

Cov ntawv sau tsis muaj ib tus neeg cov ntaub ntawv nyob rau hauv ib daim ntawv.

Kev nyiam sib tw

Cov kws sau ntawv tshaj tawm tias lawv tsis muaj kev sib tw nyiam.

Publisher's Note

Springer Nature tseem nyob nruab nrab hais txog kev txiav txim plaub ntug hauv daim duab qhia kev tshaj tawm thiab cov koom haum koom nrog. Sau cov ntsiab lus 1 Department of Anesthesiology and Critical Care, Bicêtre Hôpitaux Universitaires Paris Sud, Université Paris Saclay, AP-HP, 78 Rue du Général Leclerc, 94275 Le Kremlin Bicêtre, France. 2 Department of Anesthesiology and Critical Care, AP-HP, Beaujon, Hôpitaux Universitaires Paris Nord Val de Seine, 100 Avenue du Général Leclerc, 92110 Clichy, France. 3 Department of Anesthesiology and Critical Care, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale thiab Clinique, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Sorbonne Université, AP-HP, 47-83 Boulevard de l'50 Paris, France. Tau txais: 23 Lub Ib Hlis 2019 Txais: 5 Lub Ob Hlis 2019

Tshaj tawm hauv online 19 Feb 2019

Raws li ib tug paub zoo suav tshuaj tshuaj,cistancheyog dav siv raumob raum raug mob, mob ntevkab mob raum,thiab kev txhim kho ntawmlub raum ua haujlwm.

Cov ntaub ntawv

1. Harris A, Soyer B, Gauss T, Hamada S, Raux M, Duranteau J, et al. Prevalence thiab txaus ntshai yam tshwm sim raumob hnyavraumraug mobntawmraug mobcov neeg mob: kev tshawb fawb ntau pawg. Crit Care. Xyoo 2018; 22:344.

2. Qureshi SH, Rizvi SI, Patel NN, Murphy GJ. Meta-kev tshuaj xyuas ntawm colloids piv rau crystalloids hauv kev mob hnyav,raug mobthiab phaiscov neeg mob. Br J Surg. 2016; 103:14–26.

3. Semler MW, Self WH, Wanderer JP, Ehrenfeld JM, Wang L, Byrne DW, et al. Balanced crystalloids piv rau saline hauv cov neeg laus mob hnyav. N Engl J Med. 2018; 378:829–39.

4. Roquilly A, Loutrel O, Cinotti R, Rosenzweig E, Fleet L, Mahe PJ, et al. Sib npaug piv rau cov tshuaj chloride-nplua nuj raukua dejresuscitationnyob rau hauv cov neeg mob hlwb raug mob: ib tug randomized ob-dig muag pilot kawm. Crit Care. Xyoo 2013; 17: R77.