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在重症患者中,平衡晶体与正常盐水的比较:与随机对照试验的元分析和试验序列分析进行系统审查
Yi Chen1,2,3, Yongli Gao1,2,3
1Emergency Department of West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu City, Sichuan Province, People's Republic of China.
Therapeutics and clinical risk management
|October 18, 2023
概括
均衡的晶体化物对于重症患者来说可能是比正常盐水更好的选择,可能会降低死亡率和急性损伤. 这种益处在败血症患者中尤为明显,尽管需要进一步的研究.
科学领域:
- 关键护理医学 关键护理医学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 液体复苏 复苏 液体复苏 复苏
背景情况:
- 液体复苏对于重症患者至关重要.
- 结晶体和正常盐水之间的选择仍然是争论的主题.
研究的目的:
- 在重症患者中比较正常的盐水与平衡的晶状物.
- 评估对复合死亡率和急性损伤的影响.
主要方法:
- 对18项研究 (36,224名患者) 进行了元分析.
- 搜索的数据库包括PubMed,Embase,Medline,科学网和科克兰图书馆.
- 使用逆方差,随机效应模型和试验顺序分析 (TSA).
主要成果:
- 平衡的晶体质与较低的死亡率 (RR=0.96;95% CI 0.93,1;p=0.03) 和减少急性损伤 (RR=0.93;95% CI 0.87,0.99;p=0.03) 有关.
- 在败血症患者中,平衡的晶体体显示出明显较低的复合死亡率 (RR=0.91;95% CI 0.85,0.99;p=0.02).
- 交通安全局表示,平衡晶体合物的效果不大于10%的复合死亡率相对降低.
结论:
- 均衡的晶体可能是一个最佳的流体选择比正常的盐水对于重症患者,减少死亡率.
- 这种益处在败血症患者中更为明显.
- 需要进一步的研究来证实这些发现,并指导最佳的流体选择.
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