■糖尿病酮症酸中毒(DKA)患者的最佳复苏液仍存在争议。因此,我们的目的是评估与生理盐水相比,平衡晶体对DKA患者临床结局的影响.
我们在电子数据库中搜索了比较DKA患者平衡晶体液与生理盐水的随机对照试验,搜索期从开始到10月20日,2023年。结果是DKA的解决时间,主要不良肾脏事件,复苏后的氯化物,和低钾血症的发生率。
■我们的荟萃分析涵盖了11项试验,纳入总共753例DKA患者。平衡晶体组与生理盐水组DKA消退时间差异无统计学意义(MD-1.49,95CI-4.29~1.31,P=0.30,I2=65%),主要不良肾脏事件(RR0.88,95CI0.58至1.34,P=0.56,I2=0%),和低钾血症的发生率(RR0.80,95CI0.43至1.46,P=0.46,I2=56%)。然而,在接受平衡晶体液治疗的患者中,复苏后氯化物含量显著降低(MD-3.16,95CI-5.82~-0.49,P=0.02,I2=73%).
■在DKA患者中,与生理盐水相比,使用平衡晶体对DKA的解决时间没有影响,主要不良肾脏事件,和低钾血症的发生率。然而,使用平衡晶体可以减少复苏后的氯化物。
■https://osf.io,标识符c8f3d。
UNASSIGNED: The optimal resuscitative fluid for patients with diabetic ketoacidosis (DKA) remains controversial. Therefore, our objective was to assess the effect of balanced crystalloids in contrast to normal saline on clinical outcomes among patients with DKA.
UNASSIGNED: We searched electronic databases for randomized controlled trials comparing balanced crystalloids versus normal saline in patients with DKA, the search period was from inception through October 20th, 2023. The outcomes were the time to resolution of DKA, major adverse kidney events, post-resuscitation chloride, and incidence of hypokalemia.
UNASSIGNED: Our meta-analysis encompassed 11 trials, incorporating a total of 753 patients with DKA. There was no significant difference between balanced crystalloids and normal saline group for the time to resolution of DKA (MD -1.49, 95%CI -4.29 to 1.31, P=0.30, I2 = 65%), major adverse kidney events (RR 0.88, 95%CI 0.58 to 1.34, P=0.56, I2 = 0%), and incidence of hypokalemia (RR 0.80, 95%CI 0.43 to 1.46, P=0.46, I2 = 56%). However, there was a significant reduction in the post-resuscitation chloride (MD -3.16, 95%CI -5.82 to -0.49, P=0.02, I2 = 73%) among patients received balanced crystalloids.
UNASSIGNED: Among patients with DKA, the use of balanced crystalloids as compared to normal saline has no effect on the time to resolution of DKA, major adverse kidney events, and incidence of hypokalemia. However, the use of balanced crystalloids could reduce the post-resuscitation chloride.
UNASSIGNED: https://osf.io, identifier c8f3d.