Zhou Dongxu, He LuLu, Shi Wei, Ma Penglin
Department of Critical Care Medicine, Guiqian International General Hospital, Guiyang, China.
Front Med (Lausanne). 2025 Mar 4;12:1561619. doi: 10.3389/fmed.2025.1561619. eCollection 2025.
BACKGROUND: Fluid is an essential component of initial resuscitation in sepsis or burns. Meanwhile, the optimal strategy of titrating fluids for both of the two conditions remains uncertain. In this bibliometric analysis, we compared the similarities and differences in fluid resuscitation between sepsis and burns in recent publications. METHODS: Literatures related to fluid resuscitation in either sepsis or burns were searched in the Web of Science database Core Collection from January 1, 1992, to December 31, 2022. CiteSpace and VOSviewer was used for bibliometric analysis. RESULTS: A total of 1,549 and 468 publications on fluid resuscitation in sepsis and burns were retrieved from 1992 to 2022. Based on the occurrences, 341 and 86 high-frequency keywords were screened out from sepsis and burns publications, respectively, which were similarly categorized into 5 clusters [i.e. "mechanisms of hypovolemia" (cluster 1), "titration of fluid" (cluster 2), "outcomes or complications" (cluster 3), "pathophysiological alternations" (cluster 4), and "fluid types and others" (cluster 5)]. The high-frequency keywords of the top 20 were more concentrated in cluster 3 and cluster 2, with "mortality" ranked the top in both sepsis and burns literature. Significantly, 3 keywords in cluster 2 ranked in the top 5, including "goal directed resuscitation" (the 3rd), fluid responsiveness (the 4th) and fluid balance (the 5th) in sepsis literature, while the keywords of "microvascular exchange" (cluster 1) and "abdominal compartment syndrome" (ACS, cluster 3) ranked at the second and the fifth place in burns publications. Keyword burst analysis demonstrated that the keyword with the highest burst strength (BS) was "formula" (BS = 5.88, 2008-2014), followed by management (BS = 4.79, 2012-2022), ACS (BS = 4.76, 2006-2010), and fluid creep (BS = 4.74, 2011-2016) in burn publications, but they were dobutamine (BS = 12.31, 1992-2008), cardiac output (BS = 9.79, 1993-2001), catecholamine (BS = 9.54, 1993-2006), and consumption (BS = 7.52, 1992-2006) in sepsis literature. Moreover, the most frequently cited article in either sepsis or burns was categorized into cluster 2, that investigated goal-directed fluid therapy for sepsis and formula improvement for burns resuscitation. CONCLUSION: It was demonstrated that the research priorities in titrating fluid were mainly concentrated on targeting hemodynamics in sepsis vs. improving formula (which briefly calculates the increased microvascular permeability) in burns, while concerning of "outcomes and complications" in fluid resuscitation similarly after 1992. However, hemodynamics and microvascular permeability have been simultaneously well considered in few previous studies regarding fluid resuscitation in either sepsis or burns.
背景:液体是脓毒症或烧伤初始复苏的重要组成部分。同时,针对这两种情况滴定液体的最佳策略仍不明确。在这项文献计量分析中,我们比较了近期出版物中脓毒症和烧伤在液体复苏方面的异同。 方法:在科学网数据库核心合集中检索1992年1月1日至2022年12月31日期间与脓毒症或烧伤液体复苏相关的文献。使用CiteSpace和VOSviewer进行文献计量分析。 结果:1992年至2022年期间,共检索到1549篇关于脓毒症液体复苏的出版物和468篇关于烧伤液体复苏的出版物。根据出现频次,分别从脓毒症和烧伤出版物中筛选出341个和86个高频关键词,这些关键词被类似地分为5个聚类[即“血容量不足机制”(聚类1)、“液体滴定”(聚类2)、“结局或并发症”(聚类3)、“病理生理改变”(聚类4)以及“液体类型及其他”(聚类5)]。前20个高频关键词更集中在聚类3和聚类2中,“死亡率”在脓毒症和烧伤文献中均排名第一。值得注意的是,聚类2中的3个关键词在脓毒症文献中排名前5,包括“目标导向复苏”(第3位)、液体反应性(第4位)和液体平衡(第5位),而“微血管交换”(聚类1)和“腹腔间隔室综合征”(ACS,聚类3)的关键词在烧伤出版物中分别排名第二和第五。关键词突现分析表明,烧伤出版物中突现强度(BS)最高的关键词是“公式”(BS = 5.88,2008 - 2014年),其次是管理(BS = 4.79,2012 - 2022年)、ACS(BS = 4.76,2006 - 2010年)和液体渗漏(BS = 4.74,2011 - 2016年),但脓毒症文献中是多巴酚丁胺(BS = 12.31,1992 - 2008年)、心输出量(BS = 9.79,1993 - 2001年)、儿茶酚胺(BS = 9.54,1993 - 2006年)和消耗(BS = 7.52,1992 - 2006年)。此外,脓毒症或烧伤中被引用最频繁的文章被归类到聚类2中,该文章研究了脓毒症的目标导向液体治疗和烧伤复苏的公式改进。 结论:结果表明,滴定液体的研究重点在脓毒症中主要集中于针对血流动力学,而在烧伤中主要集中于改进公式(该公式简要计算微血管通透性增加情况),不过在1992年之后,在液体复苏中对“结局和并发症”的关注类似。然而,在先前关于脓毒症或烧伤液体复苏的研究中,很少有研究同时充分考虑血流动力学和微血管通透性。
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