Volume replacement strategies on intensive care units: results from a postal survey (Retracted Article)
Volume replacement strategies on intensive care units: results from a postal survey (Retracted Article)
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DOI：
10.1007/s001340050536
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发表时间：
1998-02-01
影响因子：
38.9
通讯作者：
Papsdorf, M
中科院分区：
文献类型：
--
作者：
Boldt, J;Lenz, M;Papsdorf, M
目的：评价德国重症监护病房（icu）容量替代策略。设计：向德国451个icu发送一份包含18个问题的邮政调查问卷。问卷发放至200个床位以上医院的普通科、外科、麻醉科、神经外科、心脏外科及内科icu。结果：回收分析问卷286份，占64%。羟乙基淀粉（HES）溶液是最常用于体积替代的溶液（总：193 ICUs， HES: 93 ICUs），其次是晶体（晶体专用：61 ICUs），而人白蛋白很少被用作首选。临床经验是给药的重要依据。诊断工具，如测量中心静脉压或肺毛细血管楔压，也起着重要作用。经常在icu上测量白蛋白/总蛋白和胶体渗透压（COP）（白蛋白常规测量：173 ICUs； COP常规测量：33 ICUs）。在大多数icu中定义了白蛋白/总蛋白的临界值。血浆白蛋白/总蛋白水平降低是给药人白蛋白最常引用的指征。只有149个icu（52%）有其单位的财务预算。结论：在不同的icu中，容积治疗的类型差异很大。该问卷支持了在重症监护病人中不存在容积治疗标准的假设。关于危重病人滥用白蛋白的新结果尚未影响容量替代的策略。
Objective: To assess volume replacement strategies on in tensive care units (ICUs) in Germany.Design: A postal survey questionnaire of 18 questions was sent to 451 ICUs in Germany. The questionnaire was sent to general, surgical, anesthesiology, neurosurgery, cardiac surgery, and medical ICUs of hospitals with more than 200 beds.Results: 286 questionnaires (64 %) were returned and analysed. Hydroxyethylstarch (HES) solution is the solution most often used for volume replacement (total: 193 ICUs, exclusively HES: 93 ICUs), crystalloids are next (crystalloids exclusively: 61 ICUs), and human albumin is used rarely as a first choice. Clinical experience is a very important argument for administering volume. Diagnostic tools, e. g. measure ment of central venous pressure or pulmonary capillary wedge pressure, also play an important role. Albumin/total protein and colloid osmotic pressure (COP) are measured often on ICUs (albumin measured routinely: 173 ICUs; COP measured routinely: 33 ICUs). Critical values for albumin/total protein are defined in most ICUs. Reduced plasma levels of albumin/total protein was the indication most often cited for administering human albumin. Only 149 ICUs (52 %) have a financial budget for their unit. Costs still do not play a major role in the choice of volume replacement on 30 ICUsConclusions: The kind of volume therapy differs widely among the different ICUs. This questionnaire supported the supposition that no standards exist for volume therapy in intensive care patients. New results concerning the abuse of albumin in the critically ill have not yet influenced strategies of volume replacement.