School of Medical Sciences, International Medical University, Kuala Lumpur 57000, Malaysia.
Trans R Soc Trop Med Hyg. 2010 May;104(5):311-2. doi: 10.1016/j.trstmh.2010.02.001. Epub 2010 Mar 5.
Permanent neurological impairment or death arising from hospital-acquired hyponatremia in both children and adults is well documented. The choice of intravenous fluids for fluid resuscitation in critically ill patients is a top priority in evidence-based medicine. The question of whether colloids in comparison to crystalloids can improve mortality in such cases remains to be answered. Well powered, randomized clinical trials addressing the comparative efficacy of different types of intravenous fluids is a high priority as is the ethical justification for such trials. The understanding of the pathophysiological process serves important information on clinical practice.
医院获得性低钠血症可导致儿童和成人出现永久性神经损伤或死亡,这一点已有充分的文献记载。在循证医学中,重症患者进行液体复苏时选择何种静脉输液是当务之急。胶体液与晶体液相比是否能改善此类情况下的死亡率,这一问题仍有待解答。开展具有充分效力的随机临床试验,以确定不同类型静脉输液的相对疗效是重中之重,此类试验的伦理正当性也同样重要。对病理生理学过程的理解为临床实践提供了重要信息。