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[体积疗法:哪种准备适用于哪种情况?]

Timo Mayerhöfer1, Georg F Lehner1, Michael Joannidis2

  • 1Gemeinsame Einrichtung für Intensiv- und Notfallmedizin, Department für Innere Medizin, Medizinische Universität Innsbruck, Anichstraße 35, 6020, Innsbruck, Österreich.

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概括

在液体治疗中,建议使用平衡晶体 (BC) 超过0.9%的化,特别是对于损伤风险较高的患者. 专和基乙烯粉在重症监护中应用有限或有害.

关键词:
结合体 结合体 结合体水晶溶液,平衡的水晶溶液,平衡的水晶溶液.通常的盐水溶液.败血症 这是一种败血症.血清白蛋白,人类

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科学领域:

  • 关键护理医学 关键护理医学
  • 腎臟病學 (nephrology) 是一種醫學.
  • 流体生理学 流体生理学

背景情况:

  • 结晶合物 (0.9% NaCl,平衡结晶合物) 和合物 (白蛋白,人工合物) 是主要的流体疗法.
  • 0.9% NaCl的高化物含量可能会对脏终点产生负面影响.
  • 关于流体类型之间的死亡率差异的证据也在讨论中.

研究的目的:

  • 评估不同流体疗法的比较疗效和安全性.
  • 提供关于在重症监护机构选择流体的指导.
  • 评估与特定的液体剂 (如基乙烯粉) 相关的风险.

主要方法:

  • 对大型临床试验 (如BaSICS,PLUS) 和元分析的审查.
  • 分析不同患者群体的和死亡终点.
  • 对特定的流体剂和适应症的证据的评估.

主要成果:

  • 分析表明,平衡的晶体化物 (BC) 与0.9%的NaCl相比具有优势,特别是在方面的结果.
  • 大规模试验显示,异质人群中死亡率没有显著差异.
  • 基乙基粉与重症监护病人的伤害有关.
  • 专的使用仅限于特定的指示,如肝硬化或败血症复苏.

结论:

  • 应优先使用平衡的晶体,特别是在患有急性损伤,酸血或高血的危险因素的患者中.
  • 专素应谨慎使用,避免常规使用.
  • 应避免在重症监护室使用基乙烯粉,因为已证明有危害性.