平衡的盐溶液与正常盐水作为小儿败血症休克的复苏液:随机对照试验的系统审查和元分析
Sudha Chandelia1, Suresh Kumar Angurana1, Shankar Prasad1
1Division of Pediatric Critical Care, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.
Journal of intensive care medicine
|February 24, 2025
概括
平衡盐溶液 (BSS) 与正常盐溶液 (NS) 相比,没有降低儿科败血症休克的死亡率. 然而,BSS与急性损伤 (AKI) 的较低率,需要置换疗法 (RRT) 和高血症有关.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 复苏液疗法是一种复苏液疗法.
- 败血栓冲击管理管理
背景情况:
- 流体复苏对于儿科败血症休克至关重要.
- 在平衡盐溶液 (BSS) 和正常盐溶液 (NS) 之间做出选择是有争议的.
- 在儿科败血症休克中比较BSS和NS的证据需要合成.
研究的目的:
- 为了比较BSS与NS的疗效和安全性,用于在患有败血性休克的儿童中进行液体复苏.
- 评估对死亡率,急性损伤 (AKI),替代疗法 (RRT) 和不良事件的影响.
主要方法:
- 随机对照试验 (RCT) 的系统审查和元分析.
- 搜索了多个数据库,包括MEDLINE,Embase和Cochrane.
- 使用Cochrane工具评估偏差风险;使用随机效应模型分析数据.
主要成果:
- 分析了五项涉及992名儿童的RCT.
- 与NS相比,BSS没有显著降低死亡率 (RR 0.82,p=0.52).
- BSS与AKI (RR 0.64,p=0.0004),RRT (RR 0.52,p=0.0008) 和高血症 (RR 0.74,p=0.0002) 的显著较低率相关.
结论:
- BSS与小儿败血症休克的死亡率降低无关.
- 在减少AKI,RRT和高血症方面,BSS显示出潜在的益处.
- 对于其他结局,如代谢酸和流体过载,需要进一步研究.
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