自由液体复苏与儿童急性胰腺炎的改善结果有关
Nicholas Norris1, Peter Farrell2, Sherif Ibrahim3
1Division of Pediatric Gastroenterology, University of Texas Southwestern Medical Center, Dallas, TX.
The Journal of pediatrics
|October 2, 2024
概括
在患有急性胰腺炎 (AP) 的儿童中,自由静脉输液治疗可能会减少重症监护室的入院. 早期与自由液体一起食显示了中度至严重AP表现的最低率.
科学领域:
- 儿科胃肠病学 儿科胃肠病学
- 关键护理医学 关键护理医学
背景情况:
- 儿童急性胰腺炎 (AP) 需要谨慎管理.
- 静脉注射液疗法是AP治疗的基石,但最佳的速率和类型仍在争论中.
研究的目的:
- 根据不同的静脉注射液疗法策略,评估患有急性胰腺炎的儿科患者的结果.
- 分析液体速率,早期肠道养和液体成分对AP结果的影响.
主要方法:
- 在2013年至2023年期间,对索引急性胰腺炎入院的观察性队列研究.
- 患者被分为自由的 (>1.5x维持液体) 和保守的 (<1.5x维持液体) 组.
- 评估的结果包括ICU入院,器官功能障碍,局部并发症和AP严重程度.
主要成果:
- 与保守管理相比,自由流体治疗与显著较低的重症监护室入院或转移率相关 (OR,0.32;P=.015).
- 自由流体和早期肠道养的结合导致中度/严重AP表现的最低率.
- 较高的自由流体率 (>2x维持) 并没有增加器官功能障碍或严重疾病的发生率.
结论:
- 患有急性胰腺炎的儿科患者可能会从自由流体治疗和早期饮食开始中受益.
- 保守的液体复苏和无口状态可能不太适合管理儿科AP.
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