流体过载和败血症儿童死亡率之间的关联:系统性审查和元分析
Jaime Fernández-Sarmiento1,2, Marco Fidel Sierra-Zuñiga3,2, María Paula Salazar González3,2
1Department of Critical Care Medicine and Pediatrics, Fundación Cardioinfantil-Instituto de Cardiología, Bogotá, Colombia jaimefe@unisabana.edu.co.
BMJ paediatrics open
|November 21, 2023
概括
败血症儿童的液体过载 (FO) 与增加的死亡率和更长的住院时间有关. 这一系统性审查强调了儿童败血症患者与FO相关的风险.
科学领域:
- 儿科 儿科 儿科
- 关键护理医学 关键护理医学
- 流行病学 流行病学
背景情况:
- 败血症是全球疾病和死亡的主要原因.
- 液体复苏是一种常见的败血症治疗方法,但可能导致液体过载 (FO).
- 了解FO对儿科败血症结果的影响至关重要.
研究的目的:
- 系统地审查和分析有关流体过载 (FO) 和败血症儿童死亡率之间的相关证据.
- 研究FO与其他不良结果之间的关系,包括机械通风,多器官功能障碍综合征 (MODS) 和住院时间.
主要方法:
- 在主要数据库 (PubMed/Medline,Embase,Cochrane,Google Scholar) 进行系统搜索,截至2022年12月.
- 包括的研究报告了儿童败血症患者在ICU入院24小时内>10%的FO.
- 分析使用了一个随机效应模型,评估偏差和异质性的风险.
主要成果:
- 分析了9项涉及2312名患者的观察性研究.
- 患有FO的儿童的死亡率明显增加 (46%对26%),机械通风的需要增加 (83%对47%).
- FO与更长的住院时间有关,但与MODS无关.
结论:
- 在儿科败血症中,在ICU入院后24小时内超过10%的液体过载与死亡率的增加有关.
- 儿科败血症的液体过载也与需要机械通风和延长住院的可能性更大有关.
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