积极的基于处方的流体管理与临床治疗 (试验液体) 临重病患者的常规护理:试点临床试验协议
Alicia Shen1, Josée Bouchard2, Javier A Neyra3
1Department of Medicine, Université de Montréal, QC, Canada.
Canadian journal of kidney health and disease
|December 15, 2025
概括
这项试点试验评估了一种基于协议的流体管理策略,用于治疗严重急性损伤 (AKI) 患者的置换疗法 (KRT). 它为未来的研究奠定了基础,研究重症患者的最佳液体清除.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 关键护理医学 关键护理医学
- 临床试验 临床试验
背景情况:
- 在ICU中的严重急性损伤 (AKI) 通常涉及流体过载,需要通过置换疗法 (KRT) 清除流体.
- 目前尚不清楚KRT重症患者的最佳流体管理策略,这导致了不同的临床实践.
研究的目的:
- 评估多中心随机对照试验 (RCT) 的可行性,将基于协议的液体清除策略与常规护理进行比较.
- 确定干预措施是否会影响接受KRT的危急病患者的累积液体平衡.
主要方法:
- 一个开放的,多中心的试点随机对照试验,涉及150名成年ICU患者,AKI接受或预计开始KRT.
- 参与者被随机分配1:1到基于协议的流体管理或常规护理,干预重点是每日流体平衡目标和KRT调整.
- 主要结局是从随机化到第五天累积液体平衡的差异.
主要成果:
- 作为次要结果,收集了可行性指标,患者结果,资源利用率,安全性和流程措施.
- 研究设计承认潜在的局限性,包括临床判断的可变性和未盲目的治疗小组.
结论:
- 探测液体试验试验为设计最终的RCT提供了必要的数据.
- 这项研究旨在为需要KRT的AKI重症患者建立最佳流体管理策略.
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