静脉注射液与0. 9%盐溶液对重症患者死亡率的影响:BaSICS随机临床试验
Fernando G Zampieri1,2, Flávia R Machado2,3, Rodrigo S Biondi2,4
1HCor Research Institute, São Paulo, Brazil.
JAMA
|August 10, 2021
概括
在危急病患者中,与盐水相比,平衡溶液没有显著改善90天的存活率. 这项研究表明,在重症监护室 (ICU) 进行液体复苏时,平衡的解决方案可能没有优势.
科学领域:
- 危急护理医学
- 肝脏病学
- 液体复苏
背景情况:
- 静脉注射液体对于重症监护室 (ICU) 患者来说至关重要.
- 之前的研究提出了不同类型的流体对患者结果的影响的问题,包括死亡率和急性损伤.
研究的目的:
- 为了比较平衡晶体溶液与盐水 (0. 9% 化) 的疗效,以改善危急病患者的90天存活率.
主要方法:
- 在巴西75个重症监护室进行了一项双盲因子随机临床试验.
- 需要液体扩张并具有不良后果的危险因素的危急患者被随机分配给平衡溶液或盐水.
- 主要测量结果是90天的生存期.
主要成果:
- 在平衡溶液组 (26. 4% 的死亡率) 和盐酸组 (27. 2% 的死亡率) 之间没有观察到90天死亡率的显著差异.
- 对死亡率的调整后危险比为0. 97 (95% CI,0. 90-1. 05),表明均衡溶液没有统计学上显著的益处.
- 在这两组中都没有报告与治疗相关的严重不良事件.
结论:
- 与0. 9%盐水相比,使用平衡溶液并没有显著降低需要液体复苏的重症患者的90天死亡率.
- 这些发现不支持在该患者群体中常规使用这种特定的平衡溶液.
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