在儿童中使用间歇性囊平衡盐溶液的术后补水:随机对照试验结果
William R Johnston1, Allison L Mak Croughan2, Rosa Hwang2
1General, Thoracic, and Fetal Surgery, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
Journal of pediatric surgery
|August 24, 2024
概括
经手术后的静脉注射平衡盐溶液的液体球是安全的和可行的,与连续输注相比,显著减少液体的管理. 这种方法为儿科手术患者提供了更生理和舒适的替代方案.
科学领域:
- 儿科手术 儿科手术
- 静脉注射液体疗法是一种静脉注射液体疗法.
- 临界护理医学 临界护理医学
背景情况:
- 传统的手术后静脉注射液通常通过连续输液使用低性乳糖溶液.
- 这种做法可能对患者来说不是最生理或最舒适的.
研究的目的:
- 为了评估术后静脉注射液的可行性,安全性和有效性,以计划体重为基础的平衡盐溶液注射.
- 为了比较这种玻尿酸注射方法与传统的持续输注低血压中含有乳糖的液体.
主要方法:
- 一项随机对照试验 (Boluses of Ringer's in Surgical Kids,BRiSK) 涉及接受选择性腹部或胸部手术的儿科患者 (1-21岁).
- 患者在手术后接受了连续的D50.45NS+20mEq/L KCl或间歇性的乳酸林格囊.
- 排除标准包括腎病,糖尿病或親腸營養. 分析了电解质,尿液输出,液体体积和不良事件.
主要成果:
- 60名患者被随机分配;没有观察到显著的基线差异.
- 玻尿酸组获得的总液体量显著减少 (0.43毫升/千克/小时 vs 1.1毫升/千克/小时,p < 0.001) 没有影响尿液输出.
- 没有发生严重的不良事件或电解质干扰;在玻尿酸治疗组中观察到轻度低血糖症 (2次),而在连续治疗组中观察到轻度高血糖症 (7次).
结论:
- 术后静脉注射液以平衡盐溶液的间歇性球体的形式进行注射是一种可行的和安全的策略.
- 与传统的连续输液方案相比,这种玻尿酸剂方法导致总液体的摄入量显著减少.
- 这些发现表明,对于儿科手术患者来说,一种更生理和可能更舒适的流体管理方法.
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