Elwan Mohammed H, Roshdy Ashraf, Elsharkawy Eman M, Eltahan Salah M, Coats Timothy J
Department of Emergency Medicine, Alexandria University, Alexandria, Egypt.
Emergency Medicine Academic Group, Department of Cardiovascular Sciences, University of Leicester, Level G Jarvis Building RMO, Infirmary Square, LE1 5WW, Leicester, UK.
Scand J Trauma Resusc Emerg Med. 2017 Mar 6;25(1):25. doi: 10.1186/s13049-017-0370-4.
Fluid therapy is a common and crucial treatment in the emergency department (ED). While fluid responsiveness seems to be a promising method to titrate fluid therapy, the evidence for its value in ED is unclear. We aim to synthesise the existing literature investigating fluid responsiveness in ED.
MEDLINE, Embase and the Cochrane library were searched for relevant peer-reviewed studies published from 1946 to present.
A total of 249 publications were retrieved of which 22 studies underwent full-text review and eight relevant studies were identified. Only 3 studies addressed clinical outcomes - including 2 randomised controlled trials and one feasibility study. Five articles evaluated the diagnostic accuracy of fluid responsiveness techniques in ED. Due to marked heterogeneity, it was not possible to combine results in a meta-analysis.
High quality, adequately powered outcome studies are still lacking, so the place of fluid responsiveness in ED remains undefined. Future studies should have standardisation of patient groups, the target response and the underpinning theoretic concept of fluid responsiveness. The value of a fluid responsiveness based fluid resuscitation protocol needs to be established in a clinical trial.
液体疗法是急诊科常见且关键的治疗方法。虽然液体反应性似乎是一种调整液体疗法的有前景的方法，但其在急诊科的价值证据尚不清楚。我们旨在综合现有关于急诊科液体反应性的文献。
检索MEDLINE、Embase和Cochrane图书馆，查找1946年至今发表的相关同行评审研究。
共检索到249篇出版物，其中22项研究进行了全文评审，确定了8项相关研究。只有3项研究涉及临床结果——包括2项随机对照试验和1项可行性研究。5篇文章评估了急诊科液体反应性技术的诊断准确性。由于显著的异质性，无法在荟萃分析中合并结果。
仍然缺乏高质量、有足够样本量的结局研究，因此液体反应性在急诊科的地位仍不明确。未来的研究应在患者群体、目标反应以及液体反应性的基础理论概念方面进行标准化。基于液体反应性的液体复苏方案的价值需要在临床试验中确定。
