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不同静脉推注速率对危重症患者液体和电解质平衡及死亡率的影响。

Impact of different intravenous bolus rates on fluid and electrolyte balance and mortality in critically ill patients.

作者信息

Othman Mutaz I, Mustafa Emad M, Alfayoumi Moayad, Khatib Mohamad Y, Nashwan Abdulqadir J

机构信息

Department of Nursing, Hamad Medical Corporation, Doha 3050, Qatar.

Department of Pharmacy, Hamad Medical Corporation, Doha 3050, Qatar.

出版信息

World J Crit Care Med. 2024 Sep 9;13(3):95781. doi: 10.5492/wjccm.v13.i3.95781.

Abstract

The effect of intravenous bolus rates on patient outcomes is a complex and crucial aspect of critical care. Fluid challenges are commonly used in critically ill patients to manage their hemodynamic status, but there is limited information available on the specifics of when, how much, and at what rate fluids should be administered during these challenges. The aim of this review is to thoroughly examine the relationship between intravenous bolus rates, fluid-electrolyte balance, and mortality and to analyze key research findings and methodologies to understand these complex dynamics better. Fluid challenges are commonly employed in managing hemodynamic status in this population, yet there is limited information on the optimal timing, volume, and rate of fluid administration. Utilizing a narrative review approach, the analysis identified nine relevant studies that investigate these variables. The findings underscore the importance of a precise and individualized approach in clinical settings, highlighting the need to tailor intravenous bolus rates to each patient's specific needs to maximize outcomes. This review provides valuable insights that can inform and optimize clinical practices in critical care, emphasizing the necessity of meticulous and exact strategies in fluid administration.

摘要

静脉推注速率对患者预后的影响是重症监护中一个复杂且关键的方面。液体冲击疗法常用于危重症患者以管理其血流动力学状态,但关于在这些冲击疗法期间何时、给予多少以及以何种速率给予液体的具体细节,可用信息有限。本综述的目的是全面研究静脉推注速率、液体 - 电解质平衡与死亡率之间的关系,并分析关键研究结果和方法,以更好地理解这些复杂的动态变化。液体冲击疗法常用于管理该人群的血流动力学状态,但关于液体输注的最佳时机、容量和速率的信息有限。采用叙述性综述方法,分析确定了九项研究这些变量的相关研究。研究结果强调了在临床环境中采用精确且个体化方法的重要性,突出了根据每位患者的特定需求调整静脉推注速率以实现最佳预后的必要性。本综述提供了有价值的见解,可为重症监护中的临床实践提供参考并进行优化,强调了在液体管理中采用细致且精确策略的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f25/11372512/a3e3978ce1cf/95781-g001.jpg

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