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重症儿童的液体积累:一个系统的审查和元分析

Victoria Carneiro Lintz¹, Rafaela Araújo Vieira¹, Fernando de Lima Carioca¹

¹Paediatric Intensive Care Unit, Department of Paediatrics, Clinics Hospital of the State University of Campinas (UNICAMP), Campinas, SP, Brazil.

EClinicalMedicine

|July 29, 2024

概括

重症儿童的液体积累 (FA) 显著增加死亡率和器官功能障碍. 密切监测液体平衡对于预防不良结果和指导治疗策略至关重要.

科学领域:

儿科重症监护医学儿科重症监护医学
腎臟病學 (nephrology) 是一種醫學.
密集护理医学密集护理医学

背景情况:

危急病患的儿童容易发生液体积累 (FA),这与不良结果有关.
FA可能导致器官功能障碍,延长机械通风,延长住院时间,并增加死亡率.
了解FA和不良结果之间的关联对于儿科重症监护至关重要.

研究的目的:

评估液体积累 (FA) 与重症儿童的不良结果之间的关联.
综合系统审查和对FA和儿科重症结局的元分析的证据.
确定FA对死亡率,器官功能障碍和儿科重症监护中的资源利用的影响.

主要方法:

来自PubMed,Embase,ClinicalTrials.gov和Cochrane图书馆 (从开始到2024年5月) 的研究的系统审查和元分析.
包括评估FA对死亡率,急性损伤和机械通风等结果的影响的儿科研究.
使用随机效应模型进行聚合分析,以确定FA与不良结果之间的关联.

主要成果:

包括120项研究 (44,682名儿童),确定了35个FA定义.
FA与死亡率增加 (OR4.36),急性损伤 (OR1.98),延长机械呼吸 (38.1小时) 和更长的ICU停留 (2.29天) 有显著关联.
在调整后的分析中,每1%的FA百分比增加都与6%的死亡率增加有关 (aOR1.06).

结论:

液体积累是危急病患儿童较差结局的重要预测因素.
临床医生应密切监测液体平衡,特别是患有器官功能障碍的腫瘤患者,以确定潜在的FA综合征.
建议采取预防措施和进一步研究干预措施,如限制性流体治疗,以减轻FA.

关键词:

危急病患儿童危急病患儿童流体积累的流体积累.流体过载是因为流体过载.儿科重症监护病房儿童重症监护病房

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