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阻燃性败血症和败血栓冲击中的限制性对自由流体疗法:系统性审查和元分析
Ahmed M Abdelbaky1, Wael G Elmasry2, Ahmed H Awad1
1Critical Care, Intensive Care Unit, Dubai Academic Health Corporation - Rashid Hospital, Dubai, ARE.
Cureus
|October 30, 2023
概括
败血症的流体管理:限制性与自由流体策略对死亡率和不良事件的结果相似. 大多数研究都倾向于限制无血管压缩剂日和机械通风需求的限制性方法.
科学领域:
- 临界护理医学 临界护理医学
- 临床试验 临床试验
- 进行元分析分析.
背景情况:
- 在败血症中进行最佳的液体管理是有争议的.
- 评估限制性与自由流体疗法对患者的结果至关重要.
研究的目的:
- 评估限制性与自由流体治疗方案对败血症患者死亡率和临床结果的影响.
- 综合来自随机对照试验的证据,对毒症的流体管理策略进行分析.
主要方法:
- 11项随机对照试验的系统综述和元分析 (2008-2023年).
- 包括4121名参与者评估90天死亡率,30天死亡率,不良事件和其他临床参数.
- 质量评估表明,在包括的研究中,偏差最小.
主要成果:
- 流体策略之间90天死亡率 (OR,0.93;P=0.30) 或30天死亡率 (OR,0.73;P=0.50) 没有统计学上显著的差异.
- 相对的不良事件率 (OR,0.81;P=0.28),住院时间和ICU入院时间.
- 在机械通风,无呼吸器日,无ICU日或无血管压缩剂日没有发现显著差异.
结论:
- 限制性和自由性流体管理策略在败血症患者中显示出可比的结果.
- 虽然总体结果相似,但一些研究表明,一些研究表明,在无血管压缩剂的日子和机械通风时,限制性方案有利于趋势.
- 进一步的研究可能会澄清特定流体策略在败血症管理中的细微益处.
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