在治疗急性糖尿病酸性脂肪酸症 (RINSE-DKA) 中,乳酸与正常盐水对比
Auriene Jamison1, Adham Mohamed1, Courtney Chedester1
1Saint Luke's Hospital of Kansas City, Kansas City, Missouri, USA.
Pharmacotherapy
|July 30, 2024
概括
在糖尿病酸症 (DKA) 管理中,乳酸林格 (LR) 液体复苏导致高离子间隙代谢酸症 (HAGMA) 的分辨率比正常盐水 (NS) 更快. 两种晶体之间没有观察到并发症或停留时间的显著差异.
科学领域:
- 内分泌学 在内分泌学.
- 腎臟病學 (nephrology) 是一種醫學.
- 关键护理医学 关键护理医学
背景情况:
- 液体复苏对于糖尿病酸性糖尿病 (DKA) 管理至关重要.
- 正常盐水 (NS),虽然建议,但与不良结果,如高酸性和急性损伤有关.
- 对于DKA治疗的最佳结晶体选择仍在调查中.
研究的目的:
- 为了比较乳酸林格 (LR) 与正常盐水 (NS) 在急性DKA管理中的疗效和安全性.
- 评估LR和NS对DKA患者关键临床结果的影响.
主要方法:
- 追溯的多中心队列研究,涉及771名患者.
- 主要结局:时间到高离子间隙代谢酸化 (HAGMA) 解析.
- 二次结果:其他酸干扰的发生率,急性损伤,脏替代疗法,胰岛素输液持续时间,住院/ICU的时间.
主要成果:
- 与NS相比,LR与HAGMA分辨率的显著更快时间有关 (aHR为1.325,p<0.001).
- 在LR和NS之间没有观察到关于非间隙代谢酸化,高血症,急性损伤或需要替代疗法的显著差异.
- 胰岛素输注时间和住院/ICU的时间在两组之间是相似的.
结论:
- 与正常盐水相比,作为DKA管理中的主要晶体质的乳酸林格 (LR) 管理加速了HAGMA分辨率.
- 在并发症和资源利用方面,LR和NS的安全性表现相似.
- 结果支持使用平衡的晶体体,如LR超过NS用于DKA治疗.
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