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AIM To evaluate the efficacy and safety of oxycodone in acute heart failure （AHF）. METHODS In this prospective randomized controlled trial, 50 AHF patients admitted to the ICU between January 2022 and December 2023 were allocated to morphine group （n=25） or oxycodone group （n=25） using random number table, received intravenous injection of 5 mg morphine or oxycodone based non-invasive ventilation, respectively. Effectiveness outcomes （comfort score,NT-proBNP, oxygenation index （OI）, ICU length of stay, non-invasive ventilation duration, and hospitalization outcomes）and safety parameters （mean arterial pressure （MAP）, heart rate （HR）, respiratory rate （RR）, minute ventilation （MV）,intubation rate, and respiratory depression） were assessed at baseline （T0）, 10 min （T1）, 20 min （T2）, 30 min （T3）,and 24 h （T4） post-treatment in the two groups. RESULTS Both groups showed significant reduction in comfort scores at T3 and increased OI at T4 compared with those of T0 （P<0.01）, and the oxycodone group demonstrated significantly lower NT-proBNP at T4 （P<0.05）, with no significant differences between the two groups（P>0.05）. No between-group differences were observed in ICU stay or ventilation duration. MAP decreased transiently in both groups: the morphine group maintained lower MAP in T1-T3 than T0（P<0.05）, whereas the oxycodone group only showed reductions at T1 and T2 （P<0.05）,with significantly higher MAP than the morphine group during T1-T3 （P<0.05）. HR exhibited biphasic changes while RR and MV progressively declined. The morphine group showed sustained RR reduction in T1-T3 than T0（P<0.05）, and the oxycodone group showed reduction at T2 and T3 （P<0.05）. Neither group required intubation or developed respiratory depression. CONCLUSION Oxycodone demonstrates favorable hemodynamic stability and potential prognostic benefits in AHF management, suggesting its promise as a novel therapeutic option.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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