背景:本系统综述讨论了氯化物在液体治疗中的临床生理学方面。晶体溶液是最广泛使用的补救措施之一。虽然通常用于医学近190年,自新千年以来,主要关注其安全性的研究才发表。最广泛使用的解决方案,生理盐水,在这种情况下最常见的是。其过度给药导致高血代谢性酸中毒与其他后果,包括更高的死亡率。
方法:通过在电子MEDLINE数据库中在线搜索,确定了符合本论文开发条件的原始论文和评论文章。搜索的关键词包括高氯血症,低氯血症,和含有“氯化物”的复合词,“输液治疗,代谢性酸中毒,肾功能衰竭,和审查。
结果:确定了2020年5月31日之前发表的21,758篇论文;其中,从列表中删除了630个重复项。在排除基于标题或摘要的文章时,对1850篇论文进行了筛选,其中63篇全文进行了评估。
结论:根据最新的医学概念,异常血症(高氯血症和低氯血症)无疑是对临床结果的选定变量产生负面影响的因素。由于输液治疗可以显着影响人体的氯化物稳态,输液的选择应始终考虑到氯含量对氯血症和器官功能的潜在不利影响.
BACKGROUND: This systematic
review discusses a clinical physiology aspect of
chloride in fluid therapy. Crystalloid solutions are one of the most widely used remedies. While generally used in medicine for almost 190 years, studies focused largely on their safety have only been published since the new millennium. The most widely used solution, normal saline, is most often referred to in this context. Its excessive administration results in hyperchloremic metabolic acidosis with other consequences, including higher mortality rates.
METHODS: Original papers and
review articles eligible for developing the present paper were identified by searching online in the electronic MEDLINE database. The keywords searched for included hyperchloremia, hypochloremia, and compound words containing the word \"chloride,\" infusion therapy, metabolic acidosis, renal failure, and
review.
RESULTS: A total of 21,758 papers published before 31 May 2020 were identified; of this number, 630 duplicates were removed from the list. Upon excluding articles based on their title or abstract, 1850 papers were screened, of which 63 full-text articles were assessed.
CONCLUSIONS: According to the latest medical concepts, dyschloremia (both hyperchloremia and hypochloremia) represents a factor indisputably having a negative effect on selected variables of clinical outcome. As infusion therapy can significantly impact
chloride homeostasis of the body, the choice of infusion solutions should always take into account the potentially adverse impact of
chloride content on chloremia and organ function.