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首页> 外文期刊>Canadian journal of anesthesia: Journal canadien d'anesthesie >Fluid resuscitation in the management of early septic shock (FINESS): a randomized controlled feasibility trial.
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Fluid resuscitation in the management of early septic shock (FINESS): a randomized controlled feasibility trial.

机译：早期感染性休克（FINESS）管理中的液体复苏：一项随机对照可行性试验。

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BACKGROUND: It is unknown whether fluid resuscitation with colloid or crystalloid in patients with severe sepsis or septic shock is associated with an improvement in clinical outcome. This randomized controlled trial determined the feasibility of conducting a large trial testing resuscitation with pentastarch vs normal saline in early septic shock, powered for a difference in mortality. METHODS: At three Canadian and one New Zealand academic centre, 40 patients with early septic shock defined by at least two systemic inflammatory response syndrome criteria, infectious source, and persistent hypotension after >or= 1 L of crystalloid fluid were recruited. Feasibility measures were patient recruitment, blinding of the study fluids, and acceptability of the goal directed algorithms. Boluses of blinded normal saline or pentastarch (500 mL - maximum 3 L or 28 mL x kg(-1)) were administered within goal directed care for the first 12 hr. RESULTS: Of 161 patients screened, 121 were excluded and 40 patients wereenrolled, for a recruitment rate of 0.75 patients/site/month. Only 57% of physicians and 54% of nurses correctly guessed the study fluid (P = 0.46 and P = 0.67, respectively). The goal directed algorithms were acceptable to 97% of physicians. CONCLUSION: The ability to recruit patients in this pilot randomized controlled trial was below expectations. Blinding of study fluids was adequate, and resuscitation algorithms were acceptable to most physicians. Methods to improve recruitment are required to enhance the feasibility of conducting a multicentre fluid resuscitation trial in early septic shock.
机译：背景：尚无严重脓毒症或败血性休克患者用胶体或晶体进行液体复苏是否会改善临床预后。这项随机对照试验确定了在早期败血症性休克中使用戊二醛与生理盐水进行复苏的大型试验测试的可行性，该方法可提高死亡率。方法：在三个加拿大和一个新西兰学术中心，招募了40例早期败血症性休克患者，这些患者至少由两个系统性炎症反应综合征标准，感染源和≥1 L的结晶液后持续性低血压所定义。可行性措施包括患者招募，研究液盲目性和目标导向算法的可接受性。在最初的12小时内，在目标指导的护理范围内给予盲目注射的生理盐水或五味子（500 mL-最大3 L或28 mL x kg（-1））。结果：在筛查的161例患者中，排除了121例，并招募了40例患者，招募率为0.75例/部位/月。只有57％的医生和54％的护士正确猜出了研究液（分别为P = 0.46和P = 0.67）。目标导向算法对97％的医生而言都是可接受的。结论：在该试验性随机对照试验中招募患者的能力低于预期。研究流体的致盲性是足够的，复苏算法对大多数医生来说都是可以接受的。需要改进招募的方法，以增强在早期败血症性休克中进行多中心液体复苏试验的可行性。

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