在状细胞血管封闭性发作期间,乳酸林格与正常盐溶液相比.
Augusta K Alwang1, Anica C Law2, Elizabeth S Klings2,3
1Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts.
JAMA internal medicine
|September 9, 2024
概括
与正常盐水 (NS) 相比,乳酸林格 (LR) 液体复苏为患有状细胞疾病 (SCD) 患者经历血管封闭性发作 (VOE) 的患者提供了轻微但显著的改善,从而改善了没有入院的日子. 建议在这些患者的液体复苏中使用LR而不是NS.
科学领域:
- 血液学 血液学 血液学
- 关键护理医学 关键护理医学
- 药理学 药理学是指药理学的学科.
背景情况:
- 状细胞疾病 (SCD) 是一种遗传性疾病,会导致疼痛的血管闭塞发作 (VOE).
- 正常盐水 (NS) 通常用于VOE期间的液体复苏,尽管有证据表明它可能会恶化状.
- 像乳酸林格 (LR) 等替代液体的比较有效性尚未得到充分证实.
研究的目的:
- 为了比较LR与NS在SCD和VOE成年患者的液体复苏中的有效性.
- 评估液体复苏选择对无住院日 (HFD) 和其他临床结果的影响.
主要方法:
- 使用Premier PINC AI数据库 (2016-2022) 进行一个多中心队列研究和目标试验模拟.
- 包括住院成年SCD VOEs在医院第一天接受LR或NS的患者.
- 主要结局是30日的HFD,使用目标最大概率估计进行分析.
主要成果:
- 与NS相比,接受LR的患者有更多的HFD (0.4天).
- LR与住院时间更短 (-0.4天) 和30天再入院率更低 (-5.8%) 相关.
- 在接受2升或更多液体的患者中,LR表现出优于NS的优势.
结论:
- 对于有VOE的SCD患者来说,LR液体复苏比NS提供了小但显著的好处.
- 在住院SCD患者经历VOE时,LR应优先于NS进行体积复苏.
- 这些发现对SCD护理中的流体管理策略有影响.
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