临界护理超声波用于体积管理:对随机试验进行系统审查,元分析和试验序列分析
Sameer Sharif1,2,3, Holden Flindall4, John Basmaji5
1Department of Medicine, Division of Emergency Medicine, McMaster University, Hamilton, ON, Canada.
Critical care explorations
|May 14, 2025
概括
重症监护超声波 (CCUS) 可以降低急性病患者的死亡率,并改善液体平衡. 然而,它对机械通风,ICU停留时间和急性损伤的影响需要进一步调查.
科学领域:
- 临界护理医学 临界护理医学
- 护理中心超声波检查
- 流体管理流体管理
背景情况:
- 急性疾病患者经常经历复杂的液体平衡挑战.
- 优化流体管理对于改善重症监护机构患者的治疗结果至关重要.
研究的目的:
- 评估重症监护超声波 (CCUS) 的安全性和有效性,以指导重症患者的体积管理.
- 综合来自随机对照试验 (RCT) 关于CCUS在流体管理中的使用的证据.
主要方法:
- 一个系统的审查和对17个RCT的元分析,涉及1765名患者.
- 在 2024 年 2 月 6 日之前搜索了多个数据库 (MEDLINE,Embase,Wiley CENTRAL).
- 评估偏见的风险和证据的确定性,使用既有方法.
主要成果:
- 使用CCUS与潜在的死亡率降低有关 (RR,0.79;低确定性).
- 服用后长达72小时的液体平衡降低了CCUS (MD,0.72 L更低;确定性低).
- 对机械通风持续时间,ICU停留时间,血管压缩剂使用,急性损伤和置换疗法的影响是不确定的 (确定性非常低).
结论:
- 以CCUS为指导的体积管理可能会降低死亡率,并改善急性疾病成年人的液体平衡.
- 关于CCUS对其他重症监护结果的影响的证据因不准确性和间接性而受到限制.
- 需要进一步进行高质量的研究,以澄清CCUS在综合重症监护管理中的作用.
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