Gelbart Ben, Schlapbach Luregn, Ganeshalingham Anusha, Ganu Subodh, Erickson Simon, Oberender Felix, Hoq Monsurul, Williams Gary, George Shane, Festa Marino
Paediatric Intensive Care Unit, Royal Children's Hospital, Melbourne, Vic, Australia.
Paediatric Critical Care Research Group, Mater Research Institute, University of Queensland, Brisbane, Qld, Australia.
Crit Care Resusc. 2018 Jun;20(2):131-138.
Fluid bolus therapy (FBT) is a widely used intervention in paediatric critical illness. The aim of this study was to describe the attitudes and practices towards FBT of paediatric intensive care doctors in Australia and New Zealand.
An internet-based survey of paediatric intensive care doctors in Australia and New Zealand between 7 and 30 November 2016.
Paediatric intensive care units with greater than 400 admissions annually.
Paediatric intensive care specialists and junior medical staff.
Preferences for FBT and markers of fluid responsiveness.
There were 106/175 respondents (61%); 0.9% saline and 4% albumin are used frequently or almost always by 86% and 57% of respondents respectively. The preferred volume and duration were 10 mL/kg in less than 10 minutes. The highest rated markers of fluid responsiveness were heart rate and blood pressure - rated as "good" or "very good" by 75% and 58% of respondents respectively. Central venous saturations and serum lactate were the highest rated biochemical markers. The most frequently expected magnitude of change for heart rate and blood pressure was 6-15% by 89% and 76% of respondents respectively. The preferred fluid composition for sepsis, trauma, traumatic brain injury and acute lung injury was 0.9% saline, and 4% albumin for post-operative cardiac surgery.
Paediatric intensive care doctors prefer 0.9% saline and 4% albumin for FBT. Heart rate and blood pressure are the most preferred markers to assess fluid responsiveness. Preferences for FBT in specific conditions exist.
液体冲击疗法（FBT）是儿科危重症中广泛使用的一种干预措施。本研究旨在描述澳大利亚和新西兰儿科重症监护医生对FBT的态度和实践。
2016年11月7日至30日对澳大利亚和新西兰的儿科重症监护医生进行基于互联网的调查。
年入院人数超过400例的儿科重症监护病房。
儿科重症监护专家和初级医务人员。
对FBT的偏好及液体反应性标志物。
共有106/175名受访者（61%）；86%的受访者经常或几乎总是使用0.9%生理盐水，57%的受访者经常或几乎总是使用4%白蛋白。首选的容量和持续时间是在不到10分钟内给予10 mL/kg。液体反应性的最高评级标志物是心率和血压，分别有75%和58%的受访者将其评为“良好”或“非常好”。中心静脉饱和度和血清乳酸是评级最高的生化标志物。89%和76%的受访者认为心率和血压最常预期的变化幅度分别为6 - 15%。脓毒症、创伤、创伤性脑损伤和急性肺损伤的首选液体成分是0.9%生理盐水，心脏手术后则首选4%白蛋白。
儿科重症监护医生在FBT中更倾向于使用0.9%生理盐水和4%白蛋白。心率和血压是评估液体反应性的最优选标志物。在特定情况下对FBT存在偏好。
