使用液体复苏算法减少腹腔综合征在烧伤重症监护室的发生率
Jasmine Peters1, Paul Won2, Julie Herrera3
1Jasmine Peters is a plastic surgery resident, University of Wisconsin School of Medicine and Public Health, Division of Plastic and Reconstructive Surgery, Madison.
Critical care nurse
|November 30, 2023
概括
在严重烧伤患者中减少液体复苏体积并没有显著降低腹腔综合征. 虽然液体的摄入量减少了,但诸如腹腔综合征发病率和尿液输出等结果仍然相似,这表明需要进一步研究.
科学领域:
- 烧伤护理和复苏治疗
- 关键护理医学 关键护理医学
- 创伤外科手术是什么
背景情况:
- 大型烧伤需要仔细的液体复苏,以平衡组织输液,防止末端器官损伤.
- 腹腔综合征是烧伤患者过度复苏的严重并发症.
- 修改液体复苏体积可能会减轻腹腔综合征并改善患者的治疗结果.
研究的目的:
- 调查在烧伤中心设置中减少液体复苏体积是否会降低腹腔综合征的发生率.
主要方法:
- 对166名严重烧伤患者 (≥20%的总体表面积) 的回顾性队列研究.
- 标准帕克兰液体复苏算法和修改后的低体积算法之间的结果比较.
- 评估液体体积,腹腔综合征发生率,腹部高血压,功能衰竭和呼吸机使用日.
主要成果:
- 经过修改的算法导致平均液体输送量显著降低 (9.4 L 与 11.8 L 相比).
- 腹腔综合征发生率是10%的修改算法对比16%的帕克兰方程 (P = .39).
- 两组之间在腹腔综合征发生率或尿液输出方面没有发现显著差异.
结论:
- 服用液体体积的显著减少并没有导致腹腔综合征发病率显著下降.
- 需要进一步匹配的前性研究,以优化严重烧伤患者的复苏策略.
- 目前的研究结果表明,需要重新评估燃烧护理中的液体复苏方案.
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