0.9%盐水与林格的乳酸作为糖尿病酸性糖尿病儿童的初始液体:双盲随机对照试验
Ashish Agarwal1, Muralidharan Jayashree2, Karthi Nallasamy1
1Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, Punjab and Haryana, India.
BMJ open diabetes research & care
|April 7, 2025
概括
林格的乳酸 (RL) 显著减少了儿童的糖尿病酸性 (DKA) 解决时间,而不是0.9%的盐水 (NS). 此外,RL还导致化物含量降低,碳酸含量增加,使其成为DKA处理的有利流体选择.
科学领域:
- 儿科内分泌学 儿科内分泌学
- 关键护理医学 关键护理医学
- 液体复苏 复苏 液体复苏 复苏
背景情况:
- 糖尿病酸症 (DKA) 是1型糖尿病 (T1DM) 的严重并发症.
- 0.9%盐水 (NS) 可以导致高血症,可能会延迟DKA解决.
- 林格的乳酸 (RL) 可能会改善DKA的结果,因为它的二碳酸盐再生特性.
研究的目的:
- 为了比较Ringer的乳酸 (RL) 与0.9%的盐液 (NS) 在解决儿童DKA的疗效.
- 评估RL和NS在DKA治疗期间对血清化物和二碳酸盐水平的影响.
主要方法:
- 一个双盲随机对照试验,涉及儿童 (9个月至12岁) 患有T1DM呈现DKA.
- 参与者接受了NS或RL用于初始复苏和液体替换.
- 主要结局是DKA解决的时间;次要结局包括生化变化和急性损伤发生率.
主要成果:
- 67名儿童被随机分配 (34名为NS,33名为RL).
- 与NS组 (16.8小时) 相比,RL组 (12.9小时) 的平均DKA解析时间较短.
- 与NS组相比,RL组的血清化物增加较小,血清二碳酸盐增加较大.
结论:
- 林格的乳酸盐 (RL) 给药导致儿科患者的糖尿病酸症 (DKA) 解决的时间更短.
- 与导致高血症的NS不同,RL能够再生二碳酸盐,这提供了一个生理上的优势.
- 对于患有DKA的儿童来说,RL是一种有利的液体复苏选择.
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