AAS：急性循环功能衰竭患者液体复苏推荐使用晶体液而非胶体液

南粤麻医

该综述认为，对于ICU患者及脓毒症患者，推荐使用晶体液，而非羟乙基淀粉、明胶或白蛋白。对于创伤患者，推荐使用晶体液，而非胶体液。对于烧伤患者，因缺乏相关数据，无推荐意见。

Acta Anaesthesiol Scand. 2014 Nov 2. doi: 10.1111/aas.12429. [Epub ahead of print]

Scandinavian clinical practice guideline on choice of fluid in resuscitation of critically ill patients with acute circulatory failure.

Perner A1, Junttila E, Haney M, Hreinsson K, Kvåle R, Vandvik PO, Møller MH.

Author information

Abstract

BACKGROUND:

The task force on Acute Circulatory Failure of the Scandinavian Society of Anaesthesiology and Intensive Care Medicine produced this guideline with recommendations concerning the use of crystalloid vs. colloid solutions in adult critically ill patients with acute circulatory failure.

METHODS:

Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology was used to grade the quality of evidence and to determine the strengths of the recommendations. As efficacy and harm may vary in different subpopulations of patients with acute circulatory failure, we produced recommendations for general intensive care unit (ICU) patients and those with sepsis, trauma and burn injury.

RESULTS:

For general ICU patients and those with sepsis, we recommend using crystalloids for resuscitation rather than hydroxyethyl starch and we suggest using crystalloids rather than gelatin and albumin. For patients with trauma we recommend to use crystalloids for resuscitation rather than colloid solutions. For patients with burn injury we provide no recommendations as there are very limited data from randomised trials on fluid resuscitation in this patient population.

CONCLUSIONS:

We recommend using crystalloid solutions rather than colloid solutions for resuscitation in the majority of critically ill patients with acute circulatory failure.

© 2014 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

PMID: 25363535

http://www.ncbi.nlm.nih.gov/pubmed/?term=25363535