Kissoon Niranjan, Bohn Desmond
University of Florida HSC/Jacksonville, Division of Pediatric Critical Care Medicine, Jacksonville, Florida 32207, USA.
Indian J Pediatr. 2003 Dec;70(12):969-73. doi: 10.1007/BF02723823.
The debate concerning the choice of crystalloids or colloids for resuscitation of the critically ill child is still unsettled. Moreover, the use of albumin in critically ill patients has been increasingly questioned because of the lack of clear-cut advantages over crystalloids as well as the concern for cost and the very minor risk of infection. Despite several meta-analyses addressing these issues, there is no data that supports the use of albumin unequivocally in any specific disease states. The suggestion that the use of albumin increases mortality in critically ill patients is not supported by data. There may be niche areas such as hypoalbuminic states, cirrhosis and burns where albumin may have distinct benefits. Alternatively synthetic colloids may be useful, however, concerns about coagulation problems and organ dysfunction persists.
关于在危重症儿童复苏中选择晶体液还是胶体液的争论仍未解决。此外，由于与晶体液相比缺乏明确优势，以及对成本和极微小感染风险的担忧，危重症患者使用白蛋白的情况越来越受到质疑。尽管有几项荟萃分析探讨了这些问题，但没有数据明确支持在任何特定疾病状态下使用白蛋白。关于白蛋白使用会增加危重症患者死亡率的说法没有数据支持。在低白蛋白血症状态、肝硬化和烧伤等特定领域，白蛋白可能有明显益处。另外，合成胶体可能有用，然而，对凝血问题和器官功能障碍的担忧依然存在。
