J Crit Care:限制性液体复苏对动脉瘤性蛛网膜下腔出血后低氧血症的影响

2017-07-25 MedSci MedSci原创

蛛网膜下腔出血(aSAH)、急性心功能不全和3-H疗法均可导致低氧血症。本研究旨在评估限制性液体复苏是否对患者低氧血症产生影响。

蛛网膜下腔出血(aSAH)、急性心功能不全和3-H疗法均可导致低氧血症。本研究旨在评估限制性液体管理是否对患者低氧血症产生影响。

我们对出血24h后入ICU的aSAH患者进行前瞻性的研究。本研究分为2个阶段,第一阶段为2012年1月至2012年12月,定义为对照组(C组)。第二阶段,从2014年2月至2015年1月,定义为研究组(组S)。在这期间,研究组的总液体摄入量在能满足液体平衡的情况下尽可能的控制到最低。

实施了有效的液体控制后:前3天累计液体平衡分别为C组1559±2402ml,S组759±1855ml(P=0.04);前7天累计液体平衡分别为C组2211±4918ml,S组529±2806ml(P=0.04)。与C组相比,S组患者在第3天(22% vs 40%,P=0.047)和第7天(28% vs 57%,P=0.007)发生低氧血症的比例均下降。

从而我们可以得出结论:对aSAH患者进行限制性液体管理,在第3天和第7天的低氧血症发生比例均下降。

原始出处:

Drevet CM1, Opprecht N1, et al. Impact of restrictive fluid protocol on hypoxemia after aneurysmal subarachnoid hemorrhage. J Crit Care. 2017 Jul 17;42:152-156. doi: 10.1016/j.jcrc.2017.07.031.

本文系梅斯医学(MedSci)原创编译整理,转载需授权!

评论区 (6)
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  1. [GetPortalCommentsPageByObjectIdResponse(id=1654442, encodeId=0aa9165444204, content=<a href='/topic/show?id=5ab788e81d3' target=_blank style='color:#2F92EE;'>#蛛网膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88781, encryptionId=5ab788e81d3, topicName=蛛网膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=396c24497244, createdName=aliceclz, createdTime=Fri Oct 27 18:03:00 CST 2017, time=2017-10-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=226718, encodeId=27f8226e18ca, content=很好,不错,以后会多学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Thu Jul 27 01:12:41 CST 2017, time=2017-07-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1305412, encodeId=83a1130541209, content=<a href='/topic/show?id=270342e249d' target=_blank style='color:#2F92EE;'>#复苏#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42724, encryptionId=270342e249d, topicName=复苏)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1d01326, createdName=lizhou0204, createdTime=Thu Jul 27 00:03:00 CST 2017, time=2017-07-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1337796, encodeId=04c8133e796ac, content=<a href='/topic/show?id=376c332e497' target=_blank style='color:#2F92EE;'>#动脉瘤性蛛网膜下腔出血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33274, encryptionId=376c332e497, topicName=动脉瘤性蛛网膜下腔出血)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/UdV6ialcayj7Qv8RQm1mVfNYPKxjiaolxwglAZpCo6CwjTicOroW2Xb0Kxnc65viaxGpkuqHW7WzzbYgRLw3qooDoA/132, createdBy=04c22500137, createdName=紫砂壶, createdTime=Thu Jul 27 00:03:00 CST 2017, time=2017-07-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1377316, encodeId=c5a913e731673, content=<a href='/topic/show?id=1d4c26235f1' target=_blank style='color:#2F92EE;'>#低氧血症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26235, encryptionId=1d4c26235f1, topicName=低氧血症)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=279b407, createdName=shanyongle, createdTime=Thu Jul 27 00:03:00 CST 2017, time=2017-07-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1556953, encodeId=5fce15569539e, content=<a href='/topic/show?id=987a6588307' target=_blank style='color:#2F92EE;'>#液体复苏#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65883, encryptionId=987a6588307, topicName=液体复苏)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=07bb14837728, createdName=luoxiaog, createdTime=Thu Jul 27 00:03:00 CST 2017, time=2017-07-27, status=1, ipAttribution=)]
    2017-10-27 aliceclz

    #蛛网膜#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1654442, encodeId=0aa9165444204, content=<a href='/topic/show?id=5ab788e81d3' target=_blank style='color:#2F92EE;'>#蛛网膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88781, encryptionId=5ab788e81d3, topicName=蛛网膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=396c24497244, createdName=aliceclz, createdTime=Fri Oct 27 18:03:00 CST 2017, time=2017-10-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=226718, encodeId=27f8226e18ca, content=很好,不错,以后会多学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Thu Jul 27 01:12:41 CST 2017, time=2017-07-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1305412, encodeId=83a1130541209, content=<a href='/topic/show?id=270342e249d' target=_blank style='color:#2F92EE;'>#复苏#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42724, encryptionId=270342e249d, topicName=复苏)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1d01326, createdName=lizhou0204, createdTime=Thu Jul 27 00:03:00 CST 2017, time=2017-07-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1337796, encodeId=04c8133e796ac, content=<a href='/topic/show?id=376c332e497' target=_blank style='color:#2F92EE;'>#动脉瘤性蛛网膜下腔出血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33274, encryptionId=376c332e497, topicName=动脉瘤性蛛网膜下腔出血)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/UdV6ialcayj7Qv8RQm1mVfNYPKxjiaolxwglAZpCo6CwjTicOroW2Xb0Kxnc65viaxGpkuqHW7WzzbYgRLw3qooDoA/132, createdBy=04c22500137, createdName=紫砂壶, createdTime=Thu Jul 27 00:03:00 CST 2017, time=2017-07-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1377316, encodeId=c5a913e731673, content=<a href='/topic/show?id=1d4c26235f1' target=_blank style='color:#2F92EE;'>#低氧血症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26235, encryptionId=1d4c26235f1, topicName=低氧血症)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=279b407, createdName=shanyongle, createdTime=Thu Jul 27 00:03:00 CST 2017, time=2017-07-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1556953, encodeId=5fce15569539e, content=<a href='/topic/show?id=987a6588307' target=_blank style='color:#2F92EE;'>#液体复苏#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65883, encryptionId=987a6588307, topicName=液体复苏)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=07bb14837728, createdName=luoxiaog, createdTime=Thu Jul 27 00:03:00 CST 2017, time=2017-07-27, status=1, ipAttribution=)]
    2017-07-27 李东泽

    很好,不错,以后会多学习

    0

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    2017-07-27 lizhou0204

    #复苏#

    0

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    2017-07-27 shanyongle
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    2017-07-27 luoxiaog

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