目的:在研究重症监护病房(ICU)中使用液体反应性和液体挑战(FC)的研究中,提供有关血液动力学数据报告的共识建议。
方法:欧洲重症监护医学学会(ESICM)执行委员会委托并监督了该项目。由18名国际专家和一名方法学家组成的小组从系统文献中确定了主要领域和项目,加上2个辅助域。使用基于迭代方法的三步Delphi过程来获得最终共识。在Delphi1和2中,选择的项目具有很强的(≥80%的投票)或周协议(70-80%的投票),而Delphi3产生推荐(≥90%的投票)或建议(80-90%的投票)项目(RI和SI,分别)。
结果:我们确定了5个主要领域,最初包括117个项目,共识最终产生了52个建议或建议:获得了18个RI和2个SI声明,用于“ICU入院”,“机械通气”域的11个RI和1个SI,域“给出FC的原因”的5个RI,FC前和FC后“血液动力学数据”域的8个RI,和“FC前输注药物”域的7个RI。我们对使用超声心动图没有共识,体积(4ml/kg)和参考变量(心输出量)的一致性很强,而在这种情况下FC的给药速率(10分钟内)较弱。
结论:这项共识发现了5个主要领域,并为调查ICU患者液体反应性的研究提供了52条数据报告建议。
OBJECTIVE: To provide consensus recommendations regarding hemodynamic data reporting in studies investigating fluid responsiveness and fluid challenge (FC) use in the intensive care unit (ICU).
METHODS: The Executive Committee of the European Society of Intensive Care Medicine (ESICM) commissioned and supervised the project. A panel of 18 international experts and a methodologist identified main domains and items from a systematic literature, plus 2 ancillary domains. A three-step Delphi process based on an iterative approach was used to obtain the final consensus. In the Delphi 1 and 2, the items were selected with strong (≥ 80% of votes) or week agreement (70-80% of votes), while the Delphi 3 generated recommended (≥ 90% of votes) or suggested (80-90% of votes) items (RI and SI, respectively).
RESULTS: We identified 5 main domains initially including 117 items and the consensus finally resulted in 52 recommendations or suggestions: 18 RIs and 2 SIs statements were obtained for the domain \"ICU admission\", 11 RIs and 1 SI for the domain \"mechanical ventilation\", 5 RIs for the domain \"reason for giving a FC\", 8 RIs for the domain pre- and post-FC \"hemodynamic data\", and 7 RIs for the domain \"pre-FC infused drugs\". We had no consensus on the use of echocardiography, strong agreement regarding the volume (4 ml/kg) and the reference variable (cardiac output), while weak on administration rate (within 10 min) of FC in this setting.
CONCLUSIONS: This consensus found 5 main domains and provided 52 recommendations for data reporting in studies investigating fluid responsiveness in ICU patients.