Precision fluid and vasoactive drug therapy for critically ill patients.
Precision fluid and vasoactive drug therapy for critically ill patients.
复制标题
危重患者的精准液体和血管活性药物治疗。
DOI：
10.1002/phar.2763
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发表时间：
2023
期刊：
影响因子：
4.1
通讯作者：
Erstad,BrianL
中科院分区：
文献类型：
--
作者：
Bauer,SethR;Gellatly,RochelleM;Erstad,BrianL
关于在危重成人患者中使用液体和血管活性药物治疗有一些临床实践指南，但这些指南中的建议通常基于低质量的证据。此外，有些是在具有里程碑意义的临床试验发表之前编制的，特别是在平衡晶体和生理盐水的比较中。在治疗危重患者时，一个重要的考虑因素是应用精准医学，为最有可能从治疗中受益的患者群体提供最有效的护理。虽然目前还没有被广泛地纳入这些实践指南，但精确医学在危重疾病中的应用是公认的流体和血管活性治疗管理的研究重点。这篇叙述性综述的目的是说明对成人危重患者提供精确流体和血管活性治疗的评估和挑战。这篇综述包括对现有临床实践指南发布后发表的重要调查的讨论，以深入了解建议和研究重点如何改变未来的指南和危重患者的床边护理。
There are several clinical practice guidelines concerning the use of fluid and vasoactive drug therapies in critically ill adult patients, but the recommendations in these guidelines are often based on low‐quality evidence. Further, some were compiled prior to the publication of landmark clinical trials, particularly in the comparison of balanced crystalloid and normal saline. An important consideration in the treatment of critically ill patients is the application of precision medicine to provide the most effective care to groups of patients most likely to benefit from the therapy. Although not currently widely integrated into these practice guidelines, the utility of precision medicine in critical illness is a recognized research priority for fluid and vasoactive therapy management. The purpose of this narrative review was to illustrate the evaluation and challenges of providing precision fluid and vasoactive therapies to adult critically ill patients. The review includes a discussion of important investigations published after the release of currently available clinical practice guidelines to provide insight into how recommendations and research priorities may change future guidelines and bedside care for critically ill patients.