Administration of the nitric oxide synthase inhibitor NG-methyl-l-arginine hydrochloride (546C88) by intravenous infusion for up to 72 hours can promote the resolution of shock in patients with severe sepsis: Results of a randomized, double-blind, placebo-controlled multicenter study (study no. 144-002)*

医学 感染性休克 麻醉 平均动脉压 安慰剂 血压 多巴酚丁胺 心脏指数 休克(循环) 中心静脉压 不利影响 去甲肾上腺素 败血症 血流动力学 重症监护 心率 心输出量 外科 药理学 内科学 多巴胺 重症监护医学 替代医学 病理
作者
Jan Bakker,Robert F. Grover,A McLuckie,L. Holzapfel,Jan Andersson,Robert F. Lodato,David I. Watson,Steven H. Grossman,Jill Donaldson,Jukka Takala
出处
期刊:Critical Care Medicine [Lippincott Williams & Wilkins]
卷期号:32 (1): 1-12 被引量:184
标识
DOI:10.1097/01.ccm.0000105118.66983.19
摘要

To assess the safety and efficacy of the nitric oxide synthase inhibitor 546C88 in patients with septic shock. The predefined primary efficacy objective was resolution of shock, defined as a mean arterial pressure > or =70 mm Hg in the absence of both conventional vasopressors and study drug, determined at the end of the 72-hr treatment period.Multicentered, randomized, placebo-controlled, safety and efficacy study.Forty-eight intensive care units in Europe, North America, and Australia.A total of 312 patients with septic shock diagnosed within 24 hr before randomization.Patients were randomly allocated to receive either 546C88 or placebo (5% dextrose) by intravenous infusion for up to 72 hrs. Conventional vasoactive therapy was restricted to norepinephrine, dopamine, and dobutamine. Study drug was initiated at 0.1 mL/kg/hr (5 mg/kg/hr 546C88) and titrated according to response up to a maximum rate of 0.4 mL/kg/hr with the objective to maintain mean arterial pressure at 70 mm Hg while attempting to withdraw any concurrent vasopressor(s).Requirement for vasopressors, systemic hemodynamics, indices of organ function and safety (including survival up to day 28) were assessed. The median mean arterial pressure for both groups was maintained >70 mm Hg. Administration of 546C88 was associated with a decrease in cardiac index while stroke index was maintained. Resolution of shock at 72 hr was achieved by 40% and 24% of the patients in the 546C88 and placebo cohorts, respectively (p =.004). There was no evidence that treatment with 546C88 had any major adverse effect on pulmonary, hepatic, or renal function. Day 28 survival was similar for both groups.In this study, treatment with the nitric oxide synthase inhibitor 546C88 promoted the resolution of shock in patients with severe sepsis. This was associated with an acceptable overall safety profile.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
所所应助小王采纳,获得10
刚刚
李健应助TT采纳,获得100
1秒前
共享精神应助Kyle采纳,获得30
2秒前
2秒前
3秒前
ledong关注了科研通微信公众号
4秒前
U9A发布了新的文献求助10
4秒前
7秒前
任伟超发布了新的文献求助10
7秒前
U9A关闭了U9A文献求助
8秒前
牙牙完成签到,获得积分10
9秒前
9秒前
9秒前
11秒前
霸气乘风完成签到,获得积分10
12秒前
Jasper应助封从霜采纳,获得10
13秒前
小王发布了新的文献求助10
13秒前
小谢发布了新的文献求助20
14秒前
15秒前
Emma发布了新的文献求助10
16秒前
19秒前
zxt完成签到,获得积分10
20秒前
Thy发布了新的文献求助10
21秒前
22秒前
U9A发布了新的文献求助10
22秒前
一一发布了新的文献求助10
22秒前
22秒前
ledong发布了新的文献求助10
23秒前
23秒前
23秒前
24秒前
24秒前
26秒前
27秒前
U9A关闭了U9A文献求助
27秒前
JINCHANG完成签到,获得积分10
27秒前
Mayday发布了新的文献求助10
27秒前
29秒前
Kyle发布了新的文献求助30
29秒前
Allen发布了新的文献求助10
30秒前
高分求助中
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
Social Research Methods (4th Edition) by Maggie Walter (2019) 1030
A new approach to the extrapolation of accelerated life test data 1000
Indomethacinのヒトにおける経皮吸収 400
基于可调谐半导体激光吸收光谱技术泄漏气体检测系统的研究 370
Phylogenetic study of the order Polydesmida (Myriapoda: Diplopoda) 370
Robot-supported joining of reinforcement textiles with one-sided sewing heads 320
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3993587
求助须知:如何正确求助?哪些是违规求助? 3534299
关于积分的说明 11265206
捐赠科研通 3274074
什么是DOI,文献DOI怎么找? 1806303
邀请新用户注册赠送积分活动 883118
科研通“疑难数据库(出版商)”最低求助积分说明 809712