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首页> 外文期刊>Journal of paediatrics and child health >International, multicentre, observational study of fluid bolus therapy in neonates
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International, multicentre, observational study of fluid bolus therapy in neonates

机译：国际，多期，新生儿流体推注疗法的观察研究

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Aim To assess the prevalence, types and indications for fluid bolus therapy in neonates with haemodynamic compromise. Methods This was a pragmatic, international, multicentre observational study in neonatal units across Australasia, Europe and North America with a predefined study period of 10–15 study days per participating neonatal unit between December 2015 and March 2017. Infants ≤28?days of age who received a fluid bolus for the management of haemodynamic compromise (≥10 mL/kg given at ≤6 h) were included. Results A total of 163 neonates received a bolus over 8479 eligible patient days in 41 neonatal units. Prevalence of fluid bolus therapy varied between centres from 0 to 28.6% of admitted neonates per day, with a pooled prevalence rate of 1.5% (95% confidence interval 1.1–1.9%). The most common fluid used was 0.9% sodium chloride (129/163; 79%), and the volume of fluid administered was most commonly 10 mL/kg (115/163; 71%) over a median of 30 min (interquartile range 20–60). The most frequent indications were hypotension ( n ?=?56; 34%), poor perfusion ( n ?=?20; 12%) and metabolic acidosis ( n ?=?20; 12%). Minimal or no clinical improvement was reported by clinicians in 66 of 163 cases (40%). Conclusions Wide international variations in types, indications and effects of fluid bolus administration in haemodynamically compromised neonates suggest uncertainty in the risk–benefit profile. This is likely to reflect the lack of robust evidence to support the efficacy of different fluid types, doses and appropriate indications. Together, these highlight a need for further clinically relevant studies.
机译：目的是评估新生儿血液中的流体推注疗法的患病率，类型和适应症与血液动力学妥协。方法这是澳大拉多亚洲，欧洲和北美的新生儿单位的务实，国际多期形观察研究，在2015年12月和2017年12月之间的每个参展新生儿单位的预定研究期为10-15个研究日。婴儿≤28？包括谁收到用于管理血液动力学折衷的流体推注（≥10ml/ kg）。结果共有163个新生儿在41个新生儿单位中获得超过8479个符合条件的患者天的推注。流体推注疗法的患病率在0％至28.6％的每天入院新生儿的中心之间变化，杂交率为1.5％（95％置信区间1.1-1.9％）。所使用的最常见的液体为0.9％氯化钠（129/163; 79％），施用的流体体积最常见于30分钟的中位数（第20次）中位数（21个-60）。最常见的适应症是低血压（n？= 56; 34％），灌注不良（n？= 20; 12％）和代谢酸中毒（n？= 20; 12％）。临床医生在163例中的66例（40％）中报告了最小或临床改善。结论血液动力学损害新生儿中流体推注施用的类型，适应症和影响的广泛国际变化表明风险福利概况的不确定性。这可能反映了缺乏稳健的证据来支持不同流体类型，剂量和适当适应症的疗效。在一起，这些突出了对进一步临床相关研究的需求。

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