Division of Pulmonary, Allergy and Critical Care, Emory University School of Medicine, Grady Memorial Hospital, 615 Michael Street, Suite 205, Atlanta, GA 30322, USA.
Crit Care. 2010;14(6):1006. doi: 10.1186/cc9305. Epub 2010 Nov 9.
The war between colloids and crystalloids wages on. In a large multinational survey of fluid prescribing practices in critically ill patients, we have a new and intriguing snapshot of global fluid resuscitation practices. Colloids are more often used for impaired perfusion or low cardiac output, and the choice of colloid or crystalloid varies enormously between countries. Why are some ICUs prescribing colloids more often than crystalloids when there is little convincing evidence that colloids are superior for fluid resuscitation? Are colloids advantageous in certain diseases, or in specific regional patient populations that have not yet been elucidated? Perhaps we should look inwards: the answer may not be more randomized clinical trials, but better adherence to current guidelines and treatment recommendations.
胶体与晶体之争仍在继续。在一项针对危重症患者液体治疗方案的大型跨国调查中，我们对全球液体复苏实践有了新的、有趣的了解。胶体更常用于灌注受损或低心输出量，不同国家之间胶体与晶体的选择差异巨大。当几乎没有令人信服的证据表明胶体在液体复苏方面具有优势时，为什么有些 ICU 更常开胶体而不是晶体？胶体在某些疾病或尚未阐明的特定地区患者人群中是否有优势？也许我们应该从内部寻找答案：答案可能不是更多的随机临床试验，而是更好地遵守当前的指南和治疗建议。
