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多个电解质溶液与盐水作为儿科败血症休克复苏的玻尿液:多中心随机临床试验
Jhuma Sankar1, Jayashree Muralidharan2, A V Lalitha3
1Division of Pediatric Pulmonology and Intensive Care, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
Critical care medicine
|June 9, 2023
概括
与盐水相比,平衡的晶体化物 (多重电解质溶液) 显著减少了儿科败血症休克的急性损伤. 这种液体选择对于改善重症儿童脏状况至关重要.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 腎臟病學 (nephrology) 是一種醫學專業.
- 败血栓冲击管理管理
背景情况:
- 儿童的感染性休克可能导致急性损伤 (AKI).
- 选择静脉注射液用于初始复苏可能会影响功能.
- 0.9%盐水是常用的,但可能有不良影响.
研究的目的:
- 为了比较平衡晶体化物 (多重电解质溶液,MES) 与0.9%盐水对功能的影响,在患有败血性休克的儿童中.
- 为了确定MES或盐水是否对该人群的功能产生不良影响.
主要方法:
- 一个平行组,盲目的多中心试验,涉及15岁以下的患有败血症休克的儿童.
- 随机选择接受MES (PlasmaLyte A) 或0.9%盐水的液体球.
- 主要结局:在7天内出现新的和/或进展的AKI;次要结局:高血症,不良事件和ICU死亡率.
主要成果:
- 与盐水相比,使用MES进行液体复苏显著降低了新/渐进性AKI的风险 (相对风险为0.62) (21%对33%).
- 在MES组中,在24,48,72小时后观察到高血的发病率较低.
- 两组之间没有发现ICU死亡率或输注相关不良事件的显著差异.
结论:
- 使用MES (平衡晶体) 进行初始液体复苏与与0.9%盐水相比,在患有感染性休克的儿童中,AKI的发病率较低.
- 均衡的晶体可能是儿童败血症休克管理的首选液体选择,以保护功能.
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