严格的流体管理与早期缓解与常规护理在重症患者 (减少试验):一个可行性随机对照试验
Thummaporn Naorungroj1,2, Ukrit Prajantasen3, Tewa Sanla-Ead4
1Division of Critical Care, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. thummaporn.nao@mahidol.ac.th.
对于患有循环休克的重症患者,限制性流体策略显著减少了流体积累和住院时间. 这种方法是可行的,并没有增加不良事件,为重症监护流体管理提供了潜在的改善.
科学领域:
- 关键护理医学 关键护理医学
- 流体管理策略 流体管理策略
- 血液动力学复苏 血液动力学复苏
背景情况:
- 在重症患者中,最佳的流体管理至关重要但复杂.
- 流体过载是循环休克患者的常见并发症.
- 液体复苏的标准护理方案需要对不同患者阶段进行仔细评估.
研究的目的:
- 评估限制性流体策略的可行性,在患有循环休克的患者中早期缓解升级.
- 为了比较限制性流体策略与医疗重症监护室环境中的标准护理.
- 评估流体管理对患者结果的影响,包括流体平衡,停留时间和不良事件.
主要方法:
- 进行了一个单中心,可行性,随机对照试验.
- 100名需要液体复苏的休克患者被随机分配到限制性液体策略或常规护理中.
- 限制性组的目标是在3天内达到接近零的液体平衡,根据需要使用利尿剂或机械液体清除.
主要成果:
- 限制性流体策略组在第3天 (2353毫升 vs. 793毫升) 和第7天 (3032毫升 vs. 1125毫升) 实现了明显较低的累积流体平衡.
- 限制性组的患者经历了更短的重症监护病房 (7 vs. 10天) 和住院时间 (16 vs. 22天).
- 两组之间死亡率,急性损伤发生率或替代疗法使用率没有显著差异.
结论:
- 限制性流体策略与早期缓和和复苏相结合,可用于患有循环休克的危急病患者.
- 这一策略有效地减少了液体积累,并显示了短期住院的趋势,而不会增加不良事件.
- 这些发现表明,限制性流体管理在优化急性流体复苏后患者护理方面具有潜在的益处.
更多相关视频
10:38Observational Study Protocol for Repeated Clinical Examination and Critical Care Ultrasonography Within the Simple Intensive Care Studies
Published on: January 16, 2019
09:36Halogenated Agent Delivery in Porcine Model of Acute Respiratory Distress Syndrome via an Intensive Care Unit Type Device
Published on: September 24, 2020
相关概念视频
Acute Respiratory Failure-V
Ensure that patients are monitored continuously for their response to therapy, including changes in...
Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
Acute Kidney Injury VI: Nursing Management
Mitral Regurgitation IV: Nursing Management
Heart Failure V: Medical Management
Endoscopic Studies II: Thoracocentesis
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
