Defining fluid removal in the intensive care unit: A national and international survey of critical care practice.
Defining fluid removal in the intensive care unit: A national and international survey of critical care practice.
复制标题
DOI：
10.1177/1751143717699423
复制
发表时间：
2017-11-01
影响因子：
2.7
通讯作者：
Prowle, John R
中科院分区：
文献类型：
--
作者：
O'Connor, Michael E;Jones, Sarah L;Prowle, John R
设计和创新：为了确定和比较重症监护病房专家在英国和澳大利亚和新西兰自我报告的定义，评估和管理液体超负荷的危重病人使用结构化的在线questionnaire.RESULTS：我们评估了219个答复。澳大利亚、新西兰和英国重症监护室专家报告称，他们使用临床检查结果、床边工具和放射学特征来评估危重患者的液体状态、诊断液体过载并开始液体清除。中心静脉压升高被认为无助于诊断液体过载，而以临床医生设定的液体平衡为目标是最流行的管理策略。肾脏替代治疗是使用之前，更多的利尿剂治疗的患者谁是寡尿/无尿，或利尿剂治疗时，没有产生足够的respons.CONCLUSIONS：这自我报告的帐户的做法，由英国和澳大利亚和新西兰重症监护医师证明，液体超负荷仍然定义不清与变异的管理和实践。
DESIGN AND OBJECTIVES: To identify and compare how intensive care unit specialists in the United Kingdom and Australia and New Zealand self-reportedly define, assess and manage fluid overload in critically ill patients using a structured online questionnaire.RESULTS: We assessed 219 responses. Australia and New Zealand and United Kingdom intensive care unit specialists reported using clinical examination findings, bedside tools and radiological features to assess fluid status, diagnose fluid overload and initiate fluid removal in the critically ill. An elevated central venous pressure is not regarded as helpful in diagnosing fluid overload and targeting a clinician-set fluid balance is the most popular management strategy. Renal replacement therapy is used ahead of more diuretic therapy in patients who are oligo/anuric, or when diuretic therapy has not generated an adequate response.CONCLUSIONS: This self-reported account of practice by United Kingdom and Australia and New Zealand intensivists demonstrates that fluid overload remains poorly defined with variability in both management and practice.