Randomised controlled trial of colloid or crystalloid in hypotensive preterm infants
Randomised controlled trial of colloid or crystalloid in hypotensive preterm infants
复制标题
胶体或晶体治疗低血压早产儿的随机对照试验
DOI：
10.1136/fn.76.1.f43
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发表时间：
1997
期刊：
影响因子：
--
通讯作者：
K. Cheung
中科院分区：
文献类型：
--
作者：
K. So;T. Fok;P. Ng;W. Wong;K. Cheung
目的比较胶体(5%白蛋白)和晶体(等渗盐水)溶液治疗机械通气早产儿低血压的疗效。方法63例早产儿出生时体重540~1950 g，胎龄23~34周，出生后2 h内发生低血压(出生体重1、1~1.49、1.5~1.99 kg，平均动脉压分别为25、30、35 mm Hg)的早产儿随机分为两组，分别静脉滴注5%白蛋白(n=32)和等渗生理盐水(n=31)。如果婴儿在总共三次输液(30ml/kg)后仍保持低血压，则给予正性肌力支持和多巴胺输注。随后，根据婴儿的血压，给予5%白蛋白形式的额外剂量的容量扩张剂。结果两组试液用量差异无统计学意义。结果，根据需要肌力支持的婴儿数量和死亡或慢性肺部疾病的数量进行评估，两组之间没有差异。然而，在正性肌力支持后，第一组需要更多的扩张器来维持正常血压(中位数：27.5ml/kgvs10ml/kg；P=0.0187)，并且在出生后48小时内平均体重增加百分比较高(24小时：6.3(1.3)%比3.3(0.8)%；P=0.049；48小时：5.9(1.9)%比0.9(1.7)%；P=0.045)。即使只比较那些不需要肌力支持或额外5%白蛋白的婴儿，48h时体重增加的差异也是显著的(组1：1.5%，组2：-4.2%(1.1)%；P=0.027)。结论等渗盐水对早产儿低血压的治疗效果与5%白蛋白相当，且48h内液体滞留较少。
AIM To compare the efficacy of a colloid (5% albumin) and a crystalloid (isotonic saline) solution for treating hypotension in mechanically ventilated preterm infants. METHODS Sixty three preterm infants weighing 540 to 1950 g at birth and with gestational ages of 23 to 34 weeks, who developed hypotension (mean arterial pressure < 25, 30, and 35 mm Hg for infants with birthweight <1, 1-1.49, and 1.5-1.99 kg, respectively) within the first 2 hours of life, were randomly allocated to receive intravenous infusions at 10 ml/kg of either 5% albumin (group 1, n=32) or isotonic (0.9%) saline (group 2, n=31). Inotropic support with dopamine infusion was given if the infants remained hypotensive after a total of three infusions (30 ml/kg). Subsequent extra doses of volume expander in the form of 5% albumin was given, depending on the infant’s blood pressure. RESULTS There was no difference in the volume of the test solutions required between the two groups. Outcome, as assessed by the number of infants requiring inotropic support and death or chronic lung disease, did not differ between the groups. After inotropic support, however, group 1 required significantly more volume expander to maintain normal blood pressure (median: 27.5 ml/kgvs 10 ml/kg; P=0.0187) and had a higher mean (SEM) percentage weight gain within the first 48 hours of life (at 24 hours: 6.3(1.3)% vs 3.3(0.8)%; P=0.049; at 48 hours: 5.9(1.9)%vs 0.9(1.7)%; P=0.045). The difference in weight gain was significant at 48 hours even when only those infants not requiring inotropic support or extra 5% albumin were compared (group 1: 1.5(1.5)%, group 2: -4.2(1.1)%; P = 0.027). CONCLUSIONS Isotonic saline is as effective as 5% albumin for treating hypotension in preterm infants, and it has the additional advantage of causing less fluid retention in the first 48 hours.
DOI：
10.1164/ajrccm.149.5.8173767
发表时间：
1994
影响因子：
24.7
作者：
Ueda,T;Ikegami,M;Jobe,A
通讯作者：
Jobe,A