Hypotonic versus Isotonic Fluids in Hospitalized Children: A Systematic Review and Meta-Analysis
Hypotonic versus Isotonic Fluids in Hospitalized Children: A Systematic Review and Meta-Analysis
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DOI：
10.1016/j.jpeds.2014.01.040
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发表时间：
2014-07-01
影响因子：
5.1
通讯作者：
Hill, Vanessa
中科院分区：
文献类型：
--
作者：
Foster, Byron Alexander;Tom, Dina;Hill, Vanessa
目的确定使用低渗和等渗维持液是否会增加住院儿童发生低钠血症的风险。研究设计检索MEDLINE(1946~2013年1月)、Cochrane中央登记处(1991~2012年12月)、护理与相关卫生文献累计索引(1990~2012年12月)和儿科学术学会(2000~2012年)的文献摘要，检索词分别为“低渗液/生理盐水/溶液”和“等渗液/生理盐水/溶液”。一次和二次结果的数据是由2位作者独立从原始文章中提取的。结果共筛选出1634条引文，对主要和次级结果进行Meta分析。纳入10项研究(n=893)，均为独立随机对照试验。五项研究检查了重症监护病房环境中的受试者，包括4名常规病房的受试者和1名混合病房的受试者。在接受维持性静脉输液的住院儿童中，接受低张输液的儿童比接受等张输液的儿童更容易出现低钠血症，总体相对危险度为2.37(95%CI，1.72-3.26)。接受低渗液与发生中度低钠血症的相对风险相关(
Objective To determine whether the use of hypotonic vs isotonic maintenance fluids confers an increased risk of hyponatremia in hospitalized children.Study design A search of MEDLINE (1946 to January 2013), the Cochrane Central Registry (1991 to December 2012), Cumulative Index for Nursing and Allied Health Literature (1990 to December 2012), and Pediatric Academic Societies (2000-2012) abstracts was conducted using the terms "hypotonic fluids/saline/solutions" and "isotonic fluids/saline/solutions," and citations were reviewed using a predefined protocol. Data on the primary and secondary outcomes were extracted from original articles by 2 authors independently. Meta-analyses of the primary and secondary outcomes were performed when possible.Results A total of 1634 citations were screened. Ten studies (n = 893) identified as independent randomized controlled trials were included. Five studies examined subjects in the intensive care unit setting, including 4 on regular wards and 1 in a mixed setting. In hospitalized children receiving maintenance intravenous fluids, hyponatremia was seen more often in those receiving hypotonic fluids than in those receiving isotonic fluids, with an overall relative risk of 2.37 (95% CI, 1.72-3.26). Receipt of hypotonic fluids was associated with a relative risk of moderate hyponatremia (