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羟乙基淀粉(HES)130/0.4被广泛应用于特护病房(ICUs)患者的液体复苏,但其对严重脓血症患者的安全性和有效性并不确切。近期Perner等研究发现,与醋酸林格氏液(Ringer’s acetate)比较,严重脓血症患者采用HES130/0.4进行液体复苏可导致患者90d死亡风险上升,且更可能需进行肾脏替代治疗。该研究将严重脓血症患者分为两组,A组(n=398)分别采用6%HES130/0.4进行液体复苏,B组(n=400)采用醋酸林格氏液进行液体复苏,两组剂量均为每天每千克理想体重33ml。比较两组复苏90d后患者死亡情况以及终末期肾功能衰竭情况。结果显示,复苏后90d,A组的398例患者中有201例死亡,死亡率为51%。
Hydroxyethyl starch (HES) 130 / 0.4 is widely used for fluid resuscitation in intensive care unit (ICUs) patients, but its safety and efficacy in patients with severe sepsis are not clear. Recent studies by Perner et al. Found that the use of HES130 / 0.4 for resuscitation in patients with severe sepsis led to a 90-day increased risk of death and was more likely to require renal replacement therapy than Ringer’s acetate. In this study, patients with severe sepsis were divided into two groups. Group A (n = 398) received liquid resuscitation with 6% HES130 / 0.4, group B (n = 400) received liquid Ringer’s solution, Dosage per day per kilogram ideal weight 33ml. The mortality and end-stage renal failure were compared between the two groups after 90 days of resuscitation. The results showed that 90 days after resuscitation, 201 of the 398 patients in group A died, the mortality rate was 51%.