印度重症监护病房中基于盐溶液或平衡溶液的趋势：一项多中心前瞻性观察队列研究（溶质研究）
Salt Based or BaLanced SolUtion-Trends Existing in Indian Intensive Care Units: A Multicenter Prospective Observational Cohort Study (SOLUTE Study).
作者信息
Gupta Sachin, Dixit Subhal, Tomar Deeksha S, Zirpe Kapil, Govil Deepak, Choudhry Dhruva, Mehta Yatin, Gupta Anand, Reddy Lakkireddigari Siva Kumar, Singamsetty Adarsh, Daram Sarala Kumari, Murthy Pooja R, Gupta Kv Venkatesha, Dileep Pratibha, Thakkar Kapildev, Patel Sweta J, Pal Divya, Paliwal Naveen, Bihani Pooja, Bavan Lakshmikanthcharan Saravana, Sivakumar M N, Ambapkar Sourabh S, Ambapkar Saanvi S, Singh Yogendra Pal, Taneja Akhil, Mishra Rajeeb K, Bharadwaj Suparna, Clerk Anuj, Patel Krunalkumar, Shah Mehul, Kaidawala Zakariya
机构信息
Department of Critical Care Medicine, Narayana Superspeciality Hospital, Gurugram, Haryana, India.
Department of Critical Care Medicine, Sanjeevan & MJM Hospital, Pune, Maharashtra, India.
出版信息
Indian J Crit Care Med. 2024 Nov;28(11):1028-1037. doi: 10.5005/jp-journals-10071-24825. Epub 2024 Oct 30.
INTRODUCTION
Fluid administration is a commonly practiced intervention in the intensive care unit (ICU) with normal saline being the preferred fluid. We sought to understand the current practice of fluid administration and choice of fluids in Indian ICUs and its effect on renal outcomes.
MATERIALS AND METHODS
The Indian Society of Critical Care Medicine (ISCCM)-endorsed multicenter prospective observational study was conducted on practice of fluid administration in critically ill patients between May 1, 2020, and January 31, 2023. SPSS software was used for statistical analysis.
RESULTS
Private sector hospitals contributed 79.16% of data out of 144 ICUs. Around 961 patients belonged to the normal saline (NS) group, 672 to the Ringer's lactate (RL) group, and 891 to the balanced salt solution (BSS) group out of 2,452 patients. Patients with chronic obstructive pulmonary disease were more in the BSS and NS group as compared to RL group ( < 0.00001). Acute kidney injury (AKI) incidence was higher in the NS group, followed by RL and BSS ( < 0.0001). The serum creatinine rise was higher in the NS group on the first 2 days ( < 0.001). Daily fluid balance, urine output, and renal replacement therapy (RRT) needs were similar among the groups. The BSS group had shorter ICU and hospital length of stay (LOS) than the NS group ( < 0.001). The ICU survival was 63.3% in the NS group and 79.44% in the BSS group ( < 0.001). The AKI patients had higher survival in the BSS group (78.81%) as compared to the NS group (63.08%) ( < 0.001).
CONCLUSION
Balanced salt solution is the preferred intravenous fluid with a safe renal profile among critically ill patients. The AKI patients had shorter hospital and ICU LOS with BSS as compared to NS.
HOW TO CITE THIS ARTICLE
Gupta S, Dixit S, Tomar DS, Zirpe K, Govil D, Choudhry D, Salt Based or BaLanced SolUtion-Trends Existing in Indian Intensive Care Units: A Multicenter Prospective Observational Cohort Study (SOLUTE Study). Indian J Crit Care Med 2024;28(11):1028-1037.
引言
在重症监护病房（ICU）中，液体输注是一种常见的干预措施，生理盐水是首选的液体。我们试图了解印度ICU中目前的液体输注实践、液体选择及其对肾脏结局的影响。
材料与方法
印度危重病医学会（ISCCM）认可的多中心前瞻性观察性研究，对2020年5月1日至2023年1月31日期间重症患者的液体输注实践进行了研究。使用SPSS软件进行统计分析。
结果
在144个ICU中，私立医院贡献了79.16%的数据。在2452例患者中，约961例属于生理盐水（NS）组，672例属于乳酸林格氏液（RL）组，891例属于平衡盐溶液（BSS）组。与RL组相比，慢性阻塞性肺疾病患者在BSS组和NS组中更多（<0.00001）。NS组急性肾损伤（AKI）发生率更高，其次是RL组和BSS组（<0.0001）。NS组在最初2天血清肌酐升高更高（<0.001）。各组间每日液体平衡、尿量和肾脏替代治疗（RRT）需求相似。BSS组的ICU和住院时间（LOS）比NS组短（<0.001）。NS组的ICU生存率为63.3%，BSS组为79.44%（<0.001）。与NS组（63.08%）相比，BSS组的AKI患者生存率更高（78.81%）（<0.001）。
结论
平衡盐溶液是重症患者中具有安全肾脏特征的首选静脉输液。与NS相比，AKI患者使用BSS时的住院和ICU住院时间更短。
如何引用本文
Gupta S, Dixit S, Tomar DS, Zirpe K, Govil D, Choudhry D, 基于盐或平衡溶液——印度重症监护病房现有的趋势：一项多中心前瞻性观察队列研究（SOLUTE研究）。《印度危重病医学杂志》2024；28(11):1028 - 1037。
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