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一项比较毛细支气管炎患儿经鼻胃管与静脉补液的前瞻性随机试验(方案):毛细支气管炎比较补液研究(CRIB)。

A prospective randomised trial comparing nasogastric with intravenous hydration in children with bronchiolitis (protocol): the comparative rehydration in bronchiolitis study (CRIB).

机构信息

Department of Emergency Medicine Monash Medical Centre, Clayton Rd, Clayton, Victoria 3168, Australia.

出版信息

BMC Pediatr. 2010 Jun 1;10:37. doi: 10.1186/1471-2431-10-37.

Abstract

BACKGROUND

Bronchiolitis is the most common reason for admission of infants to hospital in developed countries. Fluid replacement therapy is required in about 30% of children admitted with bronchiolitis. There are currently two techniques of fluid replacement therapy that are used with the same frequency-intravenous (IV) or nasogastric (NG).The evidence to determine the optimum route of hydration therapy for infants with bronchiolitis is inadequate. This randomised trial will be the first to provide good quality evidence of whether nasogastric rehydration (NGR) offers benefits over intravenous rehydration (IVR) using the clinically relevant continuous outcome measure of duration of hospital admission.

METHODS/DESIGN: A prospective randomised multi-centre trial in Australia and New Zealand where children between 2 and 12 months of age with bronchiolitis, needing non oral fluid replacement, are randomised to receive either intravenous (IV) or nasogastric (NG) rehydration.750 patients admitted to participating hospitals will be recruited, and will be followed daily during the admission and by telephone 1 week after discharge. Patients with chronic respiratory, cardiac, or neurological disease; choanal atresia; needing IV fluid resuscitation; needing an IV for other reasons, and those requiring CPAP or ventilation are excluded.The primary endpoint is duration of hospital admission. Secondary outcomes are complications, need for ICU admission, parental satisfaction, and an economic evaluation. Results will be analysed using t-test for continuous data, and chi squared for categorical data. Non parametric data will be log transformed.

DISCUSSION

This trial will define the role of NGR and IVR in bronchiolitis

TRIAL REGISTRATION

The trial is registered with the Australian and New Zealand Clinical Trials Registry--ACTRN12605000033640.

摘要

背景

在发达国家,毛细支气管炎是婴儿住院的最常见原因。约 30%的毛细支气管炎住院患儿需要补液治疗。目前有两种补液治疗技术,即静脉(IV)或鼻胃(NG)。尚无充分证据确定毛细支气管炎患儿最佳补液途径。这项随机试验将首次提供高质量证据,证明鼻胃补液(NGR)是否优于静脉补液(IVR),其临床相关的连续结局指标为住院时间。

方法/设计:这是一项在澳大利亚和新西兰进行的前瞻性随机多中心试验,研究对象为 2 至 12 个月龄、需要非口服补液的毛细支气管炎患儿,将其随机分为静脉(IV)或鼻胃(NG)补液组。将招募 750 名入组医院的患儿,并在住院期间每天进行随访,出院后 1 周通过电话进行随访。患有慢性呼吸道、心脏或神经系统疾病、后鼻孔闭锁、需要静脉补液复苏、因其他原因需要静脉补液以及需要 CPAP 或通气的患儿将被排除。主要结局指标为住院时间。次要结局指标为并发症、入住 ICU 需求、家长满意度和经济学评价。连续数据采用 t 检验分析,分类数据采用卡方检验,非参数数据采用对数转换。

讨论

该试验将明确 NGR 和 IVR 在毛细支气管炎中的作用。

试验注册

该试验在澳大利亚和新西兰临床试验注册中心注册,注册号为 ACTRN12605000033640。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b520/2903564/14279452211c/1471-2431-10-37-1.jpg

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