Obonyo Nchafatso G, Fanning Jonathon P, Ng Angela S Y, Pimenta Leticia P, Shekar Kiran, Platts David G, Maitland Kathryn, Fraser John F
Critical Care Research Group, The Prince Charles Hospital, Brisbane, Queensland, Australia.
Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya.
Intensive Care Med Exp. 2016 Dec;4(1):38. doi: 10.1186/s40635-016-0112-3. Epub 2016 Nov 21.
Recent research has identified an increased rate of mortality associated with fluid bolus therapy for severe sepsis and septic shock, but the mechanisms are still not well understood. Fluid resuscitation therapy administered for sepsis and septic shock targets restoration of the macro-circulation, but the pathogenesis of sepsis is complex and includes microcirculatory dysfunction.
The objective of the study is to systematically review data comparing the effects of different types of fluid resuscitation on the microcirculation in clinically relevant animal models of lipopolysaccharide-induced sepsis.
A structured search of PubMed/MEDLINE and EMBASE for relevant publications from 1 January 1990 to 31 December 2015 was performed, in accordance with PRISMA guidelines.
The number of published papers on sepsis and the microcirculation has increased steadily over the last 25 years. We identified 11 experimental animal studies comparing the effects of different fluid resuscitation regimens on the microcirculation. Heterogeneity precluded any meta-analysis.
Few animal model studies have been published comparing the microcirculatory effects of different types of fluid resuscitation for sepsis and septic shock. Biologically relevant animal model studies remain necessary to enhance understanding regarding the mechanisms by which fluid resuscitation affects the microcirculation and to facilitate the transfer of basic science discoveries to clinical applications.
近期研究发现，对于严重脓毒症和脓毒性休克，液体冲击疗法的死亡率有所上升，但其机制仍未完全明确。针对脓毒症和脓毒性休克进行的液体复苏疗法旨在恢复大循环，但脓毒症的发病机制复杂，包括微循环功能障碍。
本研究的目的是系统回顾比较不同类型液体复苏对脂多糖诱导的脓毒症临床相关动物模型微循环影响的数据。
按照PRISMA指南，对1990年1月1日至2015年12月31日期间PubMed/MEDLINE和EMBASE上的相关出版物进行结构化检索。
在过去25年中，关于脓毒症和微循环的已发表论文数量稳步增加。我们确定了11项比较不同液体复苏方案对微循环影响的实验动物研究。异质性排除了任何荟萃分析。
很少有动物模型研究发表，比较不同类型液体复苏对脓毒症和脓毒性休克微循环的影响。仍需要开展具有生物学相关性的动物模型研究，以增进对液体复苏影响微循环机制的理解，并促进基础科学发现向临床应用的转化。
