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多发伤患者晶体液与胶体液复苏的系统评价

Crystalloid vs colloid fluid resuscitation in polytrauma patients: a systematic review.

作者信息

Dormann Julia, Dahms Karolina, Steinfeld Eva, Ansems Kelly, Janka Heidrun, Metzendorf Maria-Inti, Breuer Thomas, Horst Klemens, Hildebrand Frank, Marx Gernot, Benstoem Carina

机构信息

Department of Intensive Care Medicine and Intermediate Care, Medical Faculty, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany.

Institute of General Practice, Medical Faculty of the Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany.

出版信息

Eur J Trauma Emerg Surg. 2025 Aug 11;51(1):271. doi: 10.1007/s00068-025-02921-8.

DOI:10.1007/s00068-025-02921-8
PMID:40788415
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12339606/
Abstract

PURPOSE

The question of whether crystalloid or colloid fluid yields better outcomes in the treatment of polytrauma patients has recently garnered significant interest. This systematic review aims to comprehensively compare the effects of crystalloid versus colloid fluid resuscitation on treatment outcomes in polytrauma patients.

METHODS

We searched PubMed, Cochrane Central Register of Controlled Trials and Web of Science to identify completed and ongoing studies from inception of each database to August 9, 2022. We included systematic reviews and randomized controlled trials (RCTs) comparing crystalloid versus colloid fluid resuscitation on treatment outcomes in polytrauma patients admitted to the intensive care unit (ICU).

RESULTS

We included one RCT with a total of 2,857 adult participants (mean age 63 years in the colloids and crystalloids group, 62.2% male in the colloids group and 62.5% male in the crystalloids group). Our findings indicate that the administration of crystalloids does not significantly differ from colloids in terms of 28-day mortality among polytrauma patients. (HR 1.19; 95% CI 0.54 to 2.62; RD 23 more per 1000, 95% CI 58 fewer to 174 more, 1 study, 177 participants, very low quality of evidence).

CONCLUSION

Crystalloid volume therapy has no significant difference on adult polytrauma patients compared to colloid volume therapy regarding mortality.

摘要

目的

晶体液或胶体液在多发伤患者治疗中哪种能产生更好的疗效这一问题最近引起了广泛关注。本系统评价旨在全面比较晶体液与胶体液复苏对多发伤患者治疗结局的影响。

方法

我们检索了PubMed、Cochrane对照试验中心注册库和科学网，以确定从每个数据库建立之初到2022年8月9日完成和正在进行的研究。我们纳入了比较晶体液与胶体液复苏对入住重症监护病房（ICU）的多发伤患者治疗结局影响的系统评价和随机对照试验（RCT）。

结果

我们纳入了一项RCT，共有2857名成年参与者（胶体液组和晶体液组的平均年龄均为63岁，胶体液组男性占62.2%，晶体液组男性占62.5%）。我们的研究结果表明，在多发伤患者的28天死亡率方面，晶体液的使用与胶体液没有显著差异。（风险比1.19；95%置信区间0.54至2.62；每1000人多23例，95%置信区间少58例至多174例，1项研究，177名参与者，证据质量极低）。

结论

在死亡率方面，与胶体液容量治疗相比，晶体液容量治疗对成年多发伤患者没有显著差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c02/12339606/9f7bf6f5bd03/68_2025_2921_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c02/12339606/a18be0a99951/68_2025_2921_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c02/12339606/9f7bf6f5bd03/68_2025_2921_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c02/12339606/a18be0a99951/68_2025_2921_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c02/12339606/9f7bf6f5bd03/68_2025_2921_Fig2_HTML.jpg

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