用平衡或不平衡液体的单个小体积液体玻尿酸对和酸状态的影响:一项前性随机试点研究 (FLURES试验)
M Raes1,2,3, J A Kellum4, R Colman5
1Department of Intensive Care Medicine, Department of Internal Medicine and Pediatrics, Ghent University Hospital, Ghent University, Ghent, Belgium. matthias.raes@uzbrussel.be.
Journal of nephrology
|March 28, 2024
概括
在重症患者中,单次注射盐水可显著增加血清化物,并导致高血症. 像Plasmalyte这样的平衡溶液可能为液体复苏提供更安全的替代方案.
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.
- 临床化学 临床化学
背景情况:
- 液体复苏是重症监护的基石.
- 静脉注射液的选择可能会影响酸和电解质平衡.
- 盐水 (0.9% NaCl) 是常用的,但可能有不良影响.
研究的目的:
- 为了比较单次液体注射盐水与Plasmalyte对重症患者酸状态,电解质水平和尿液输出的短期影响.
主要方法:
- 进行了一项前性,随机,受控试验.
- 成年ICU患者接受了1升盐水或1升血酸盐.
- 血液样本和尿液输出在多个时间点收集.
主要成果:
- 盐酸玻尿酸显著增加了血清化物,并减少了明显的强离子差异和过量.
- 在盐水组中观察到高血症的17%增加.
- 两组之间没有发现尿量,血压或血管压缩剂需求的显著差异.
结论:
- 即使是一个单一的,微小的盐溶液,也会显著改变重症患者的电解质和酸平衡.
- 盐水的使用增加了高血的发生率.
- 盐水和Plasmalyte之间没有观察到血液动力学参数或尿液输出的差异.
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