在重症儿童中确定液体平衡优化的机会
Denise C Hasson1, Ami Shah1, Chloe G Braun2
1Dept of Pediatrics, Hassenfeld Children's Hospital at NYU Langone Health, NY, NY.
Journal of intensive care medicine
|July 16, 2025
概括
流体过载在儿科重症监护室 (PICU) 中很常见. 了解特定位置的液体平衡 (FB) 驱动因素和障碍对于改善患者管理和结果至关重要.
科学领域:
- 儿科重症监护室的儿童重症监护室
- 临界护理医学 临界护理医学
- 流体平衡管理 流体平衡管理
背景情况:
- 流体过载 (FO) 是儿科重症监护室 (PICU) 的一个重要问题,与增加的发病率和死亡率有关.
- 准确的流体平衡 (FB) 报告和管理是具有挑战性的,因为不同 PICU 的需求和局限性各不相同.
研究的目的:
- 为了调查累积流体平衡 (CFB) 在ICU第1天和第2天超过5%和10%的流行情况.
- 确定特定地点的积极FB驱动因素,准确FB记录的障碍,以及改进的机会.
主要方法:
- 一项同时进行的混合方法研究,在四个三级儿科重症监护室中使用了回顾性和前性设计.
- 从电子健康记录中提取FB数据,并使用联合数据收集框架.
- 在ICU第1天和第2天分析了%CFB,使用统计测试对不同地点的结果进行了比较.
主要成果:
- 第二天CFB>5%在不同地点的范围从39%到54%,>10%从16%到25%.
- 在第一天的尿液记录和液体管理中观察到显著的位置间变化.
- 准确的FB报告的常见障碍包括患者/家庭报告和标准化图表的问题.
结论:
- 高%的CFB在儿科ICU中普遍存在,在各机构之间存在显著差异.
- 针对个人ICU特定的FO驱动因素对于有效的流体平衡管理至关重要.
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