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ROC trials update on prehospital hypertonic saline resuscitation in the aftermath of the US-Canadian trials.创伤后使用高渗盐水院前复苏的 ROC 试验更新：来自美加试验后的结果。
Clinics (Sao Paulo). 2013 Jun;68(6):883-6. doi: 10.6061/clinics/2013(06)25.
2
Hypertonic resuscitation: design and implementation of a prehospital intervention trial.高渗复苏：一项院前干预试验的设计与实施
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Prehospital hypertonic saline resuscitation attenuates the activation and promotes apoptosis of neutrophils in patients with severe traumatic brain injury.院前高渗盐水复苏可减轻严重创伤性脑损伤患者中性粒细胞的激活并促进其凋亡。
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Out-of-hospital hypertonic resuscitation following severe traumatic brain injury: a randomized controlled trial.院外高渗复苏治疗严重创伤性脑损伤：一项随机对照试验。
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Small-volume fluid resuscitation with hypertonic saline prevents inflammation but not mortality in a rat model of hemorrhagic shock.在失血性休克大鼠模型中，用高渗盐水进行小容量液体复苏可预防炎症，但不能降低死亡率。
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Controversies in shock research: hypertonic resuscitation--pros and cons.休克研究中的争议：高渗复苏——利弊
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The effectiveness of prehospital hypertonic saline for hypotensive trauma patients: a systematic review and meta-analysis.院前高渗盐水对低血压创伤患者的有效性：一项系统评价和荟萃分析。
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Hypertonic saline for prehospital treatment of traumatic brain injury.高渗盐水用于创伤性脑损伤的院前治疗。
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Hypertonic saline infusion does not improve the chance of primary fascial closure after damage control laparotomy: a randomized controlled trial.高渗盐水输注并不能提高损伤控制性剖腹术后一期筋膜闭合的机会：一项随机对照试验。
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Low-volume resuscitation using polyethylene glycol-20k in a preclinical porcine model of hemorrhagic shock.在失血性休克的临床前猪模型中使用聚乙二醇-20k进行小容量复苏。
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Prehospital Resuscitation of Traumatic Hemorrhagic Shock with Hypertonic Solutions Worsens Hypocoagulation and Hyperfibrinolysis.用高渗溶液进行创伤性失血性休克的院前复苏会加重低凝血症和高纤维蛋白溶解。
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Collider bias in trauma comparative effectiveness research: the stratification blues for systematic reviews.创伤比较效果研究中的对撞机偏倚：系统评价中的分层难题
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Hemodynamic responses elicited by systemic injections of isotonic and hypertonic saline in hemorrhaged rats.失血性休克大鼠全身注射等渗和高渗盐水后的血液动力学反应。
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本文引用的文献

1
Resuscitation of traumatic hemorrhagic shock patients with hypertonic saline-without dextran-inhibits neutrophil and endothelial cell activation.高渗盐水复苏创伤失血性休克患者时不添加右旋糖酐可抑制中性粒细胞和内皮细胞的激活。
Shock. 2012 Oct;38(4):341-50. doi: 10.1097/SHK.0b013e3182635aca.
2
Continuous controlled-infusion of hypertonic saline solution in traumatic brain-injured patients: a 9-year retrospective study.颅脑损伤患者持续控制性输注高渗盐水：一项 9 年回顾性研究。
Crit Care. 2011;15(5):R260. doi: 10.1186/cc10522. Epub 2011 Oct 28.
3
3% and 5% hypertonic saline.3%和5%的高渗盐水。
J Trauma. 2011 May;70(5 Suppl):S25-6. doi: 10.1097/TA.0b013e31821a5585.
4
The hypertonic saline trial: a possible downside to the gold standard of double blinding.高渗盐水试验：双盲这一黄金标准可能存在的一个弊端。
Ann Surg. 2011 Mar;253(3):442-3. doi: 10.1097/SLA.0b013e31820d32d0.
5
Out-of-hospital hypertonic resuscitation after traumatic hypovolemic shock: a randomized, placebo controlled trial.创伤性低血容量休克后院外高渗复苏：一项随机、安慰剂对照试验。
Ann Surg. 2011 Mar;253(3):431-41. doi: 10.1097/SLA.0b013e3181fcdb22.
6
The Toronto prehospital hypertonic resuscitation--head injury and multiorgan dysfunction trial: feasibility study of a randomized controlled trial.多伦多院前高渗复苏-颅脑损伤和多器官功能障碍试验：一项随机对照试验的可行性研究。
J Crit Care. 2011 Aug;26(4):363-72. doi: 10.1016/j.jcrc.2010.08.021. Epub 2010 Nov 23.
7
Out-of-hospital hypertonic resuscitation following severe traumatic brain injury: a randomized controlled trial.院外高渗复苏治疗严重创伤性脑损伤：一项随机对照试验。
JAMA. 2010 Oct 6;304(13):1455-64. doi: 10.1001/jama.2010.1405.
8
Clinical experience using 5% hypertonic saline as a safe alternative fluid for use in trauma.将5%高渗盐水用作创伤治疗中安全替代液体的临床经验。
J Trauma. 2010 May;68(5):1172-7. doi: 10.1097/TA.0b013e3181d76d40.
9
Blood loss and transcapillary refill in uncontrolled treated hemorrhage in dogs.狗未控制的治疗性出血中的失血量和毛细血管再充盈。
Clinics (Sao Paulo). 2010;65(1):67-78. doi: 10.1590/S1807-59322010000100011.
10
Prehospital resuscitation with hypertonic saline-dextran modulates inflammatory, coagulation and endothelial activation marker profiles in severe traumatic brain injured patients.院前高渗盐水-右旋糖酐复苏可调节严重创伤性脑损伤患者的炎症、凝血和内皮激活标志物谱。
J Neuroinflammation. 2010 Jan 18;7:5. doi: 10.1186/1742-2094-7-5.

创伤后使用高渗盐水院前复苏的 ROC 试验更新：来自美加试验后的结果。

ROC trials update on prehospital hypertonic saline resuscitation in the aftermath of the US-Canadian trials.

机构信息

U.S. Army Institute of Surgical Research, San Antonio, TX, USA.

出版信息

Clinics (Sao Paulo). 2013 Jun;68(6):883-6. doi: 10.6061/clinics/2013(06)25.

DOI:10.6061/clinics/2013(06)25
PMID:23778489
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3674305/
Abstract

The objectives of this review are to assess the current state of hypertonic saline as a prehospital resuscitation fluid in hypotensive trauma patients, particularly after the 3 major Resuscitation Outcomes Consortium trauma trials in the US and Canada were halted due to futility. Hemorrhage and traumatic brain injury are the leading causes of death in both military and civilian populations. Prehospital fluid resuscitation remains controversial in civilian trauma, but small-volume resuscitation with hypertonic fluids is of utility in military scenarios with prolonged or delayed evacuation times. A large body of pre-clinical and clinical literature has accumulated over the past 30 years on the hemodynamic and, most recently, the anti-inflammatory properties of hypertonic saline, alone or with dextran-70. This review assesses the current state of hypertonic fluid resuscitation in the aftermath of the failed Resuscitation Outcomes Consortium trials.

摘要

本次综述的目的在于评估高渗盐水作为创伤性低血压患者院前复苏液的现状，尤其是在美国和加拿大的 3 项主要复苏结局联合会创伤试验因无效而停止之后。出血和创伤性脑损伤是军队和平民人群中导致死亡的主要原因。院前液体复苏在平民创伤中仍存在争议，但在需要长时间或延迟后送的军事场景中，小容量高渗液复苏具有一定作用。在过去的 30 年中，积累了大量关于高渗盐水的临床前和临床文献，涉及到其血流动力学作用，以及最近涉及到的高渗盐水与右旋糖酐-70 联合应用的抗炎作用。本综述评估了复苏结局联合会试验失败后高渗液复苏的现状。