Rochwerg Bram, Włudarczyk Anna, Szczeklik Wojciech, Alhazzani Waleed, Sindi Anees, Alshamsi Fayez, Ip Wang-chun, Wang Michael, Altayyar Sultan, Li Guowei, Fox-Robichaud Alison, Guyatt Gordon
Pol Arch Med Wewn. 2013;123(11):603-8. doi: 10.20452/pamw.1972. Epub 2013 Nov 4.
Fluid therapy is one of the cornerstones of initial management of sepsis, but the choice of fluids used for resuscitation is controversial.
While trying to determine the effects of alternative fluids used in sepsis resuscitation randomized controlled trials (RCTs), we found that the precise description of those fluids was frequently not available. This report presents the result of our efforts to provide the characteristics of those fluids to both researchers and clinicians.
We searched the following electronic databases: CENTRAL, MEDLINE, EMBASE, CINAHL, and ACPJC, and examined the reference lists of recently published meta‑analyses of fluid therapies in critically ill patients. These databases were searched from inception until August 2013. The data abstraction stage included determination of fluid composition, pH, chloride concentration, and presence or absence of buffers. We relied on the original articles as well as on manufacturers' websites, contact with authors, and contact with experts in the field.
Our original search yielded 7002 articles. In consecutive stages, we reduced it to 20. The types of fluids varied widely, including chloride content (110-154 mmol/l) and presence or absence of buffering substances in colloid solutions. Those characteristics were frequently not presented and rarely emphasized in the original articles.
The basic characteristics of fluids used in fluid therapy trials are often not easily available, yet of increasingly recognized clinical importance. We provide the information concerning composition of fluids used in RCTs, which will be useful not only to future investigators and systematic reviewers but also to clinicians using those fluids in regular clinical practice.
液体疗法是脓毒症初始治疗的基石之一，但用于复苏的液体选择存在争议。
在试图确定脓毒症复苏中使用的替代液体的效果时，我们发现随机对照试验（RCT）中对这些液体的精确描述常常难以获取。本报告展示了我们为向研究人员和临床医生提供这些液体特性所做努力的结果。
我们检索了以下电子数据库：考克兰系统评价数据库（CENTRAL）、医学索引数据库（MEDLINE）、荷兰医学文摘数据库（EMBASE）、护理及健康领域数据库（CINAHL）和澳大利亚和新西兰内科医师学会杂志（ACPJC），并查阅了近期发表的危重症患者液体疗法荟萃分析的参考文献列表。这些数据库从建库起至2013年8月进行检索。数据提取阶段包括确定液体成分、pH值、氯化物浓度以及是否存在缓冲剂。我们依靠原始文章、制造商网站、与作者联系以及与该领域专家联系。
我们最初的检索得到7002篇文章。在连续的阶段中，我们将其缩减至20篇。液体类型差异很大，包括氯化物含量（110 - 154 mmol/L）以及胶体溶液中是否存在缓冲物质。这些特性在原始文章中常常未被呈现且很少被强调。
液体疗法试验中使用的液体的基本特性往往不易获取，但临床重要性日益得到认可。我们提供了关于随机对照试验中使用的液体成分的信息，这不仅对未来的研究者和系统评价者有用，而且对在常规临床实践中使用这些液体的临床医生也有用。
