南非一家儿科重症监护病房的液体超负荷情况。
Fluid overload in a South African pediatric intensive care unit.
作者信息
Ketharanathan Naomi, McCulloch Mignon, Wilson Clare, Rossouw Beyra, Salie Shamiel, Ahrens Johan, Morrow Brenda M, Argent Andrew C
机构信息
Division of Intensive Care and Pediatric Surgery, Department of Pediatrics, Intensive Care Unit, Erasmus Medical Center, Sophia Children's Hospital, Rotterdam, 3015GJ, The Netherlands
Division of Pediatric Critical Care and Children's Heart Disease, Department of Pediatric Medicine, University of Cape Town and Red Cross War Memorial Children's Hospital, Cape Town 7700, South Africa.
出版信息
J Trop Pediatr. 2014 Dec;60(6):428-33. doi: 10.1093/tropej/fmu041. Epub 2014 Aug 11.
OBJECTIVE
Fluid resuscitation is integral to resuscitation guidelines and critical care. However, fluid overload (FO) yields increased morbidity.
METHODS
Prospective observational study of Red Cross War Memorial Children's Hospital pediatric intensive care unit admissions (February to March 2013). FO % = (fluid in minus fluid out) [liters]/weight [kg] × 100%.
PRIMARY OUTCOMES
FO ≥ 10%, 28 day mortality.
RESULTS
Median [interquartile range (IQR)] age: 9.5 (2.0-39.0) months, median (IQR) admission weight: 7.9 (3.6-13.7) kg. Median (IQR) FO with admission weight: 3.5 (2.1-4.9)%; three patients had FO ≥ 10%. The 28 day mortality was 10% (n = 10). Patients who died had higher mean (IQR) FO using admission weight [4.9 (2.9-9.3)% vs. 3.4 (1.9-4.8)%; p = 0.04].
CONCLUSIONS
Low FO ≥ 10% prevalence with 28 day mortality 10%. Higher FO% with admission weight associated with mortality (p = 0.04). We advocate further investigation of FO% as a simple bedside tool.
目的
液体复苏是复苏指南和重症监护的重要组成部分。然而，液体超负荷（FO）会增加发病率。
方法
对红十字会战争纪念儿童医院儿科重症监护病房2013年2月至3月收治的患儿进行前瞻性观察研究。FO% =（输入液体量 - 输出液体量）[升]/体重[千克]×100%。
主要结局
FO≥10%，28天死亡率。
结果
年龄中位数[四分位间距（IQR）]：9.5（2.0 - 39.0）个月，入院体重中位数（IQR）：7.9（3.6 - 13.7）千克。入院时体重的FO中位数（IQR）：3.5（2.1 - 4.9）%；3例患者FO≥10%。28天死亡率为10%（n = 10）。死亡患者入院时体重的平均（IQR）FO更高[4.9（2.9 - 9.3）%对3.4（1.9 - 4.8）%；p = 0.04]。
结论
FO≥10%的患病率较低，28天死亡率为10%。入院时体重的FO%较高与死亡率相关（p = 0.04）。我们主张进一步研究将FO%作为一种简单的床边工具。
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