进入重症监护室的心脏骤停患者的液体平衡和结果
Marie Renaudier1,2, Jean-Baptiste Lascarrou3, Jonathan Chelly4
1Medical Intensive Care Unit, AP-HP Centre, Cochin Hospital, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France. marie.renaudier@aphp.fr.
Critical care (London, England)
|April 14, 2025
概括
医院外心脏骤停 (OHCA) 后的积极液体平衡与更高的死亡率有关. 限制性流体治疗可能会改善OHCA幸存者的结果.
科学领域:
- 关键护理医学 关键护理医学
- 心血管研究研究心血管研究
- 紧急医疗 紧急医疗
背景情况:
- 心脏骤停后的冲击严重影响死亡率.
- 流体平衡在心脏骤停后的血液动力学状况管理中的作用尚不清楚.
- 这项研究研究了积极的液体平衡和医院外心脏骤停 (OHCA) 患者的结果之间的关联.
研究的目的:
- 评估积极的液体平衡和患者在医院外心脏骤停 (OHCA) 后的结果之间的关联.
主要方法:
- 一项多中心研究从2020年8月到2022年6月在17个重症监护室招募了成年OHCA患者.
- 主要终点是90天的生存期.
- 分析包括多变量考克斯分析,倾向性得分匹配和基准分析与灵敏度分析.
主要成果:
- 在816名患者中,74%的体液平衡呈阳性;36%的患者在90天后存活下来.
- 阳性流体平衡与死亡率显著相关 (调整HR=1.8,p<0.001),并显示出剂量依赖的关系.
- 具有阳性液体平衡的患者增加了对置换疗法的需求,并降低了PaO2/FiO2比率.
结论:
- 阳性液体平衡始终与心脏骤停后患者的表现更差有关.
- 限制性流体治疗方法可能对OHCA后的患者有益.
- 需要进一步的研究来确认最佳的流体管理策略.
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