背景:斯堪的纳维亚麻醉学和重症监护医学学会急性循环衰竭工作组制定了本指南,并建议使用晶体与成人重症急性循环衰竭患者的胶体溶液。
方法:建议评估的分级,使用开发和评估(GRADE)方法对证据质量进行评级并确定建议的优势。由于急性循环衰竭患者的不同亚群的疗效和危害可能不同,我们为普通重症监护病房(ICU)患者和败血症患者提供了建议,创伤和烧伤。
结果:对于普通ICU患者和脓毒症患者,我们建议使用晶体而不是羟乙基淀粉进行复苏,我们建议使用晶体而不是明胶和白蛋白.对于创伤患者,我们建议使用晶体复苏而不是胶体溶液。对于烧伤患者,我们没有提供任何建议,因为该患者人群中有关液体复苏的随机试验数据非常有限。
结论:我们建议在大多数急性循环衰竭的危重患者中使用晶体溶液而不是胶体溶液进行复苏。
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.