f1000推荐麻醉与镇痛领域2012的top文献 - 新青年麻醉论坛

2013-2-12 16:23 上传

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作者: zzrxhl 时间: 2013-2-17 20:48
排名第一的是一篇f1000因子为37的文献
37 Total number of stars （f1000因子）
Hydroxyethyl starch 130/0.42 versus Ringer's acetate in severe sepsis.
羟乙基淀粉130/0.42与醋酸林格氏液在严重的败血症。
Perner A, Haase N, Guttormsen AB, Tenhunen J.N Engl J Med.2012 Jul 12; 367(2):124-34
结论：与接受林格氏液醋酸比较，重度脓毒症患者用HES130/0.42液体复苏有增加90天后死亡的危险性，可能更需要肾脏替代治疗。
附件原文及f1000评论
ch 130 versus Ringers acetate in severe sepsis.PDF
Hydroxyethyl starch 130在f1000的评论.doc(314.5k)

Abstract
BACKGROUND:
Hydroxyethyl starch (HES) [corrected] is widely used for fluid resuscitation in intensive care units (ICUs), but its safety and efficacy have not been established in patients with severe sepsis.

METHODS:
In this multicenter, parallel-group, blinded trial, we randomly assigned patients with severe sepsis to fluid resuscitation in the ICU with either 6% HES 130/0.42 (Tetraspan) or Ringer's acetate at a dose of up to 33 ml per kilogram of ideal body weight per day. The primary outcome measure was either death or end-stage kidney failure (dependence on dialysis) at 90 days after randomization.

RESULTS:
Of the 804 patients who underwent randomization, 798 were included in the modified intention-to-treat population. The two intervention groups had similar baseline characteristics. At 90 days after randomization, 201 of 398 patients (51%) assigned to HES 130/0.42 had died, as compared with 172 of 400 patients (43%) assigned to Ringer's acetate (relative risk, 1.17; 95% confidence interval [CI], 1.01 to 1.36; P=0.03); 1 patient in each group had end-stage kidney failure. In the 90-day period, 87 patients (22%) assigned to HES 130/0.42 were treated with renal-replacement therapy versus 65 patients (16%) assigned to Ringer's acetate (relative risk, 1.35; 95% CI, 1.01 to 1.80; P=0.04), and 38 patients (10%) and 25 patients (6%), respectively, had severe bleeding (relative risk, 1.52; 95% CI, 0.94 to 2.48; P=0.09). The results were supported by multivariate analyses, with adjustment for known risk factors for death or acute kidney injury at baseline.

CONCLUSIONS:
Patients with severe sepsis assigned to fluid resuscitation with HES 130/0.42 had an increased risk of death at day 90 and were more likely to require renal-replacement therapy, as compared with those receiving Ringer's acetate. (Funded by the Danish Research Council and others; 6S ClinicalTrials.gov number, NCT00962156.).

作者: zzrxhl 时间: 2013-2-17 20:51
f1000专家对 Hydroxyethyl Starch or Saline for Fluid Resuscitation in Intensive Care.
在重症监护室羟乙基淀粉或生理盐水的液体复苏。
的评价

1、Tom Woodcock的评论

Southampton General Hospital, Southampton, Hants, UK.

Changes clinical practice - For safety reasons, clinicians should use crystalloids for resuscitation, instead of synthetic colloids. 为了安全，临床复苏应使用晶体类代替人工胶体

This article is long awaited and bound to be another classic contribution from The George Institute for Global Health in Sydney, Australia. We have learned from previous studies in patients with sepsis that starches are nephrotoxic and reduce the probability of survival {1,2}. Apologists have suggested that the therapeutic failure of starch colloid solutions is due to the leaky capillaries in sepsis. In this trial, fewer than 30% of subjects had sepsis and there is no suggestion that starch was more effective or conferred any benefit in the non-septic population. Thanks to the Crystalloid Versus Hydroxyethyl Starch Trials (CHEST) investigators. If you are still using synthetic colloids, now is the time to learn crystalloid-based resuscitation. Trial registration: NCT00935168

References

1Intensive insulin therapy and pentastarch resuscitation in severe sepsis.

Brunkhorst FM, Engel C, Bloos F, Meier-Hellmann A, ..., . N Engl J Med 2008 Jan 10; 358(2):125-39

2.Hydroxyethyl starch 130/0.42 versus Ringer's acetate in severe sepsis.

Perner A, Haase N, Guttormsen AB, Tenhunen J, up, Scandinavian Critical Care Trials Group. N Engl J Med 2012 Jul 12; 367(2):124-34

2、Scott Brudney and Srinivas Pyati的评论

Duke University, Durham, NC, USA.

Changes clinical practice - This study definitively shows the need for starches to be removed from the intensive care unit (ICU) for the treatment of septic patients. 这篇研究最终显示icu脓毒血症患者治疗应避免使用淀粉类交替

更多专家的评价及相关文献请看附件

for Fluid Resuscitation in Intensive Care的篇评论.doc(56.0k) 在线查看

原文在pubmed的摘要
N Engl J Med. 2012 Nov 15;367(20):1901-11. doi: 10.1056/NEJMoa1209759. Epub 2012 Oct 17.

Hydroxyethyl starch or saline for fluid resuscitation in intensive care.

Myburgh JA, Finfer S, Bellomo R, Billot L, Cass A, Gattas D, Glass P, Lipman J, Liu B, McArthur C, McGuinness S, Rajbhandari D,Taylor CB, Webb SA; CHEST Investigators; Australian and New Zealand Intensive Care Society Clinical Trials Group.

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Destroy user interface control Collaborators (287)

Source

Division of Critical Care and Trauma, George Institute for Global Health, Sydney, NSW, Australia. [email protected]

Abstract

BACKGROUND:

The safety and efficacy of hydroxyethyl starch (HES) for fluid resuscitation have not been fully evaluated, and adverse effects of HES on survival and renal function have been reported.

METHODS:

We randomly assigned 7000 patients who had been admitted to an intensive care unit (ICU) in a 1:1 ratio to receive either 6% HES with a molecular weight of 130 kD and a molar substitution ratio of 0.4 (130/0.4, Voluven) in 0.9%sodium chloride or 0.9% sodium chloride (saline) for all fluid resuscitation until ICU discharge, death, or 90 days after randomization. The primary outcome was death within 90 days. Secondary outcomes included acute kidney injury and failure and treatment with renal-replacement therapy.

RESULTS:

A total of 597 of 3315 patients (18.0%) in the HES group and 566 of 3336 (17.0%) in the saline group died (relative risk in the HES group, 1.06; 95% confidence interval [CI], 0.96 to 1.18; P=0.26). There was no significant difference in mortality in six predefined subgroups. Renal-replacement therapy was used in 235 of 3352 patients (7.0%) in the HES group and 196 of 3375 (5.8%) in the saline group (relative risk, 1.21; 95% CI, 1.00 to 1.45; P=0.04). In the HES and saline groups, renal injury occurred in 34.6% and 38.0% of patients, respectively (P=0.005), and renal failure occurred in 10.4% and 9.2% of patients, respectively (P=0.12). HES was associated with significantly more adverse events (5.3% vs. 2.8%, P<0.001).

CONCLUSIONS:

In patients in the ICU, there was no significant difference in 90-day mortality between patients resuscitated with 6% HES (130/0.4) or saline. However, more patients who received resuscitation with HES were treated with renal-replacement therapy. (Funded by the National Health and Medical Research Council of Australia and others; CHEST ClinicalTrials.gov number, NCT00935168.).

作者: zzrxhl 时间: 2013-2-17 20:53
f1000推荐麻醉与镇痛领域2012的top文献

Hydroxyethyl starch 130/0.42 versus Ringer's acetate in severe sepsis.
羟乙基淀粉130/0.42与醋酸林格氏液在严重的败血症。
Total number of stars （f1000因子）37
Perner A, Haase N, Guttormsen AB, Tenhunen J.N Engl J Med.2012 Jul 12; 367(2):124-34
文献的意义
Changes Clinical Practice、Clinical Trial、Clinical Trial: RCT、Confirmation、Controversial、Good for Teaching
、New Finding

Risk factors associated with ischemic optic neuropathy after spinal fusion surgery.
Postoperative Visual Loss Study Group. Anesthesiology. 2012 Jan; 116(1):15-24
Total number of stars 13
脊柱融合手术后缺血性视神经病变相关的危险因素。

Unidirectional cross-activation of GRPR by MOR1D uncouples itch and analgesia induced by opioids.
MOR1D单向交叉激活GRPR分开阿片类药物引起的瘙痒和镇痛
Total number of stars 12
Liu XY, Liu ZC, Sun YG, Ross M,. Cell. 2011 Oct 14; 147(2):447-58

Transfusion strategies for acute upper gastrointestinal bleeding.
急性上消化道出血的输血策略。
Total number of stars 11
Villanueva C, Colomo A, Bosch A, Concepción M, .N Engl J Med. 2013 Jan 3; 368(1):11-21
Changes Clinical Practice、Clinical Trial、Clinical Trial: RCT、Confirmation、Good for Teaching、Interesting Hypothesis
、New Finding

Returning from Oblivion: Imaging the Neural Core of Consciousness.
L?ngsj? JW, Alkire MT, Kaskinoro K, Hayama H, J Neurosci. 2012 Apr 4; 32(14):4935-43
从遗忘中恢复：意识的神经核的成像。
Total number of stars 11
Good for Teaching、Interesting Hypothesis、New Finding、

Dexmedetomidine vs midazolam or propofol for sedation during prolonged mechanical ventilation: two randomized controlled trials.
右美托咪定与咪达唑仑或异丙酚镇静在长时间机械通气的两项随机对照试验。
Total number of stars 11
Jakob SM, Ruokonen E, Grounds RM, Sarapohja T, Garratt C, Pocock SJ, Bratty JR, Takala J. JAMA. 2012 Mar 21; 307(11):1151-60
Clinical Trial、Clinical Trial: RCT、Confirmation、New Finding

Engagement of descending inhibition from the rostral ventromedial medulla protects against chronic neuropathic pain.
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Total number of stars 11
De Felice M, Sanoja R, Wang R, Vera-Portocarrero L,. Pain. 2011 Dec; 152(12):2701-9
Confirmation、Controversial、Interesting Hypothesis、New Finding

Prediction of haematoma growth and outcome in patients with intracerebral haemorrhage using the CT-angiography spot sign (PREDICT): a prospective observational study.
Demchuk AM, Dowlatshahi D, Rodriguez-Luna D, Molina CA,. Lancet Neurol. 2012 Apr; 11(4):307-14
脑出血患者使用CT血管造影斑点标记预测血肿增长与预后：一项前瞻性观察研究。
Total number of stars 9
Confirmation、Interesting Hypothesis、New Finding、Technical Advance

Erasure of a spinal memory trace of pain by a brief, high-dose opioid administration.
短暂的大剂量的阿片类药物擦除的脊椎的疼痛记忆痕迹。
Drdla-Schutting R, Benrath J, Wunderbaldinger G, Sandkühler J. Science. 2012 Jan 13; 335(6065):235-8
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Adverse event reporting in randomised controlled trials of neuropathic pain: considerations for future practice.
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Cornelius VR, Sauzet O, Williams JE, Ayis S, Farquhar-Smith P, Ross JR, Branford RA, Peacock JL. Pain. 2013 Feb; 154(2):213-20
Total number of stars 8
Clinical Trial、Confirmation、Systematic Review / Meta-analysis

Hydroxyethyl Starch or Saline for Fluid Resuscitation in Intensive Care.
在重症监护室羟乙基淀粉或生理盐水的液体复苏。
Myburgh JA, Finfer S, Bellomo R, Billot L, ...,. N Engl J Med. 2012 Oct 17
Total number of stars 8
Changes Clinical Practice、Clinical Trial、Clinical Trial: RCT、Confirmation、Controversial
Good for Teaching、New Finding

Protecting the infant brain during cardiac surgery: a systematic review.
系统评价：在心脏手术中婴幼儿的脑保护。
Total number of stars 8
Hirsch JC, Jacobs ML, Andropoulos D, Austin EH, ..., Thorac Surg. 2012 Oct; 94(4):1365-73
Clinical Trial
Systematic Review / Meta-analysis

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感染性心内膜炎的早期手术治疗与常规治疗。
Kang DH, Kim YJ, Kim SH, Sun BJ,. N Engl J Med. 2012 Jun 28; 366(26):2466-73
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Clinical Trial、Clinical Trial: RCT、Confirmation、Controversial、New Finding

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Kline RP, Pirraglia E, Cheng H, De Santi S, Anesthesiology. 2012 Mar; 116:603-12
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Controversial、Interesting Hypothesis、New Finding

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Herridge MS, Tansey CM, Matté A, Tomlinson G,. N Engl J Med. 2011 Apr 7; 364(14):1293-304
Total number of stars 8
Confirmation、New Finding

Association between a chloride-liberal vs chloride-restrictive intravenous fluid administration strategy and kidney injury in critically ill adults.
在危重成年人，限制与不限制氯的静脉输液管理战略和肾损伤的关系
Yunos NM, Bellomo R, Hegarty C, Story D, Ho L, Bailey M. JAMA. 2012 Oct 17; 308(15):1566-72
Total number of stars 7
Clinical Trial、Clinical Trial: Non-RCT、Controversial、Interesting Hypothesis、New Finding

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Reginster JY, Badurski J, Bellamy N, Bensen W, Ann Rheum Dis. 2013 Feb; 72(2):179-86
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Total number of stars 7
Clinical Trial、Clinical Trial: RCT、Interesting Hypothesis、New Finding

作者: carina305 时间: 2013-2-18 17:13
Association between a chloride-liberal vs chloride-restrictive intravenous fluid administration strategy and kidney injury in critically ill adults.
在危重成年人，限制与不限制氯的静脉输液管理战略和肾损伤的关系

作者: hanna 时间: 2013-2-21 13:57
回复 1# zzrxhl

非常好，谢谢分享。楼主好人呐

作者: frog_0612 时间: 2013-2-22 10:27
这里面确实有好多在临床上挺有实用价值的文章
感谢楼主

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