重症儿童液体积累的决定因素:一个前性的单中心队列研究
Shannon Mohoric1, Rashid Alobaidi1, Tegan McGraw2
1Department of Pediatrics, Division of Pediatric Critical Care Medicine, University of Alberta and Stollery Children's Hospital, 4-546 Edmonton Clinic Health Academy; 11405 112 Street, Edmonton, AB, T6G 1C9, Canada.
Pediatric nephrology (Berlin, Germany)
|July 14, 2025
概括
在重症儿童中,更高的液体摄入量,特别是维持液体,是液体积累 (FA) 的主要原因. 这种FA与更长的重症监护停留时间有关.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 重症监护病房 (ICU) 的管理人员.
- 流体平衡和复苏治疗
背景情况:
- 液体积累 (FA) 是重症监护中的一个重要问题,与增加的发病率和死亡率相关.
- 了解儿科重症监护中FA的来源对于优化患者的治疗结果至关重要.
研究的目的:
- 识别和量化危急儿童饮用液体的主要原因.
- 在这个人群中调查液体摄入量,液体积累和临床结果之间的关联.
主要方法:
- 一项前性队列研究是在三级儿科重症监护病房进行的.
- 精心监测液体摄入量和输出量,重点关注维护,营养,药物和复苏液体.
- 统计分析探讨了液体摄入量,FA超过人体体重的5%,以及不使用机械通风和重症监护的天数之间的联系.
主要成果:
- 维护液体占总液体摄入量的最大比例 (37.4%),其次是营养 (23.2%).
- 在FA峰值>5%的儿童中,与FA≤5%的儿童相比,观察到更高的总体液体摄入量和输出量.
- 总体液体摄入量与FA>5% (或1.09) 独立相关,峰值FA%与更少的无密集护理日有关 (影响大小-0.30).
结论:
- 增加的液体摄入量,特别是维护液体,是FA的主要驱动因素,而不是产量下降.
- 优化维护流体计算需要进一步调查,以减轻FA并改善患者的康复.
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