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Does this critically ill patient with oliguria need more fluids, a vasopressor, or neither?

作者信息

Schortgen Frédérique, Schetz Miet

机构信息

Medical Intensive Care Unit, Henri Mondor University Hospital, Assistance publique-Hôpitaux de Paris (AP-HP), Créteil, France.

Division of Cellular and Molecular Medicine, Clinical Department and Laboratory of Intensive Care Medicine, KU Leuven University, Herestraat 49, 3000, Louvain, Belgium.

出版信息

Intensive Care Med. 2017 Jun;43(6):907-910. doi: 10.1007/s00134-017-4744-x. Epub 2017 Mar 14.

DOI:10.1007/s00134-017-4744-x
PMID:28293703
Abstract
摘要

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Does this critically ill patient with oliguria need more fluids, a vasopressor, or neither?这位少尿的重症患者需要更多补液、使用血管加压药，还是两者都不需要？
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Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016.拯救脓毒症运动：脓毒症和脓毒性休克管理国际指南：2016 年版。
Intensive Care Med. 2017 Mar;43(3):304-377. doi: 10.1007/s00134-017-4683-6. Epub 2017 Jan 18.
2
Restricting volumes of resuscitation fluid in adults with septic shock after initial management: the CLASSIC randomised, parallel-group, multicentre feasibility trial.限制初始治疗后脓毒性休克成人复苏液量：CLASSIC 随机、平行组、多中心可行性试验。
Intensive Care Med. 2016 Nov;42(11):1695-1705. doi: 10.1007/s00134-016-4500-7. Epub 2016 Sep 30.
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Understanding oliguria in the critically ill.
Simulation of Vancomycin Exposure Using Trough and Peak Levels Achieves the Target Area under the Steady-State Concentration-Time Curve in ICU Patients.
使用谷浓度和峰浓度模拟万古霉素暴露可使ICU患者达到稳态浓度-时间曲线下的目标面积。
Antibiotics (Basel). 2023 Jun 27;12(7):1113. doi: 10.3390/antibiotics12071113.
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The correlation of intraoperative oliguria with acute kidney injury after noncardiac surgery: a systematic review and meta-analysis.术中少尿与非心脏手术后急性肾损伤的相关性：系统评价和荟萃分析。
Int J Surg. 2023 Mar 1;109(3):449-457. doi: 10.1097/JS9.0000000000000284.
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Measured versus estimated creatinine clearance in critically ill patients with acute kidney injury: an observational study.急性肾损伤重症患者实测与估算的肌酐清除率：一项观察性研究
Acute Crit Care. 2022 May;37(2):185-192. doi: 10.4266/acc.2021.01256. Epub 2022 Apr 22.
6
Hemodynamically stable oliguric patients usually do not respond to fluid challenge.血流动力学稳定且少尿的患者通常对液体冲击无反应。
Rev Bras Ter Intensiva. 2020 Oct-Dec;32(4):564-570. doi: 10.5935/0103-507X.20200094.
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Optimal VAsopressor TitraTION in patients 65 years and older (OVATION-65): protocol and statistical analysis plan for a randomised clinical trial.65 岁及以上患者最佳血管加压素滴定（OVATION-65）：一项随机临床试验的方案和统计分析计划。
BMJ Open. 2020 Nov 14;10(11):e037947. doi: 10.1136/bmjopen-2020-037947.
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Less is more: ten reasons for considering to discontinue unproven interventions.少即是多：考虑停止未经证实的干预措施的十个理由。
Intensive Care Med. 2019 Nov;45(11):1626-1628. doi: 10.1007/s00134-019-05740-9. Epub 2019 Aug 21.
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Mottling score is a strong predictor of 14-day mortality in septic patients whatever vasopressor doses and other tissue perfusion parameters.斑驳评分是无论升压剂量和其他组织灌注参数如何，脓毒症患者 14 天死亡率的强有力预测指标。
Crit Care. 2019 Jun 10;23(1):211. doi: 10.1186/s13054-019-2496-4.
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