Resuscitation Fluids for Patients at High Risk of Multiple Organ Dysfunction Syndromes: A Systematic Review and Meta-analysis
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Background: Intravenous fluid therapy is one of the most common interventions in critically ill patients. Normal saline is frequentlyused, but there have been some concerns about hyperchloremia. Due to closer to plasma composition, crystalloids have been used asalternatives to normal saline. However, the optimal choice of resuscitative fluids remains controversial. Methods: MEDLINE,EMBASE, and CENTRAL were comprehensively searched until July 2021 to compare balanced crystalloids with normal saline incritically ill patients with the risk factors for multiple organ dysfunction syndromes (MODS).The primary endpoint was compositemortality. Secondary outcomes were acute kidney injury (AKI)/acute renal failure (ARF), and new receipt of renal replacementtherapy (RRT). Results: A total of 1,240 studies were searched, and finally, 8 randomized controlled trials and 5 cohort studies wereincluded. In the meta-analysis of composite mortality of 30,710 patients, balanced crystalloids compared to normal saline weresignificantly associated with reduced mortality (OR 0.80, 95% CI 0.68-0.95). In AKI/ARF, balanced crystalloids had a lower riskthan normal saline (OR 0.91, 95% CI 0.84-0.99). There was no difference between balanced crystalloids and normal saline in risk ofnew receipt of RRT (OR 0.91, 95% CI 0.80-1.04). Conclusion: In fluid resuscitation for patients at high risk of MODS, the use ofbalanced crystalloids showed a significantly lower incidence of mortality compared to normal saline.
Abstract
Background: Intravenous fluid therapy is one of the most common interventions in critically ill patients. Normal saline is frequentlyused, but there have been some concerns about hyperchloremia. Due to closer to plasma composition, crystalloids have been used asalternatives to normal saline. However, the optimal choice of resuscitative fluids remains controversial. Methods: MEDLINE,EMBASE, and CENTRAL were comprehensively searched until July 2021 to compare balanced crystalloids with normal saline incritically ill patients with the risk factors for multiple organ dysfunction syndromes (MODS).The primary endpoint was compositemortality. Secondary outcomes were acute kidney injury (AKI)/acute renal failure (ARF), and new receipt of renal replacementtherapy (RRT). Results: A total of 1,240 studies were searched, and finally, 8 randomized controlled trials and 5 cohort studies wereincluded. In the meta-analysis of composite mortality of 30,710 patients, balanced crystalloids compared to normal saline weresignificantly associated with reduced mortality (OR 0.80, 95% CI 0.68-0.95). In AKI/ARF, balanced crystalloids had a lower riskthan normal saline (OR 0.91, 95% CI 0.84-0.99). There was no difference between balanced crystalloids and normal saline in risk ofnew receipt of RRT (OR 0.91, 95% CI 0.80-1.04). Conclusion: In fluid resuscitation for patients at high risk of MODS, the use ofbalanced crystalloids showed a significantly lower incidence of mortality compared to normal saline.
참고문헌 (52)
- "Clinical guideline: Intravenous fluid therapy in adults in hospital"[URL]
- Li H, "0.9% saline is neither normal nor physiological", J Zhejiang Univ Sci B, 17(3), pp.181~187 (2016)
- Pfortmueller CA, "Acetate-buffered crystalloid fluids: current knowledge, a systematic review", J Crit Care, 35, pp.96~104 (2016)
- Potura E, "An acetate-buffered balanced crystalloid versus 0.9% saline in patients with end-stage renal disease undergoing cadaveric renal transplantation: a prospective randomized controlled trial", Anesth Analg, 120(1), pp.123~129 (2015)
- Orbegozo D, "Effects of different crystalloid solutions on hemodynamics, peripheral perfusion, and the microcirculation in experimental abdominal sepsis", Anesthesiology, 125(4), pp.744~754 (2016)
- Kellum JA, "Effects of hyperchloremic acidosis on arterial pressure and circulating inflammatory molecules in experimental sepsis", Chest, 125(1), pp.243~248 (2004)
- Neyra JA, "Association of hyperchloremia with hospital mortality in critically ill septic patients", Crit Care Med, 43(9), pp.1938~1944 (2015)
- Yunos NM, "Association between a chloride-liberal vs chloride-restrictive intravenous fluid administration strategy and kidney injury in critically ill adults", JAMA, 308(15), pp.1566~1572 (2012)
- McCluskey SA, "Hyperchloremia after noncardiac surgery is independently associated with increased morbidity and mortality : a propensity-matched cohort study", Anesth Analg, 117(2), pp.412~421 (2013)
- Kimura S, "Association of serum chloride concentration with outcomes in postoperative critically ill patients : a retrospective observational study", J Intensive Care, 23(2), pp.39~45 (2014)
- Wilcox CS, "Regulation of renal blood flow by plasma chloride", J Clin Invest, 71(3), pp.726~735 (1983)
- Jackson CD, "Choice of intravenous crystalloid fluid and mortality in critically ill adult patients", South Med J, 112(7), pp.401~405 (2019)
- Semler MW, "Balanced crystalloids versus saline in critically ill adults", N Engl J Med, 378(9), pp.829~839 (2018)
- de-Madaria E, "Fluid resuscitation with lactated Ringer’s solution vs normal saline in acute pancreatitis: A triple-blind, randomized, controlled trial", United European Gastroenterol J, 6(1), pp.63~72 (2018)
- Duffy RA, "Normal saline versus Normosol™-R in sepsis resuscitation : A retrospective cohort study", J Intensive Care Soc, 20(3), pp.223~230 (2019)
- Lipinski M, "Fluid resuscitation in acute pancreatitis : Normal saline or lactated Ringer's solution?", World J Gastroenterol, 21(31), pp.9367~9372 (2015)
- Brown DL, "Cardiac Intensive Care-E-Book", pp.208~215 (2018), Elsevier Health Sciences
- Guerci P, "Critical Care Nephrology", pp.518~524 (2019), Elsevier
- Bennett JE, "Mandell, Douglas, and Bennett's Principles and Practice of Infectious Disease", pp.990~1008 (2019), Springer
- Porro L.J, "Total Burn Care", pp.415~419 (2012), Elsevier Inc
- Schoenberg MH, "Outcome of patients with sepsis and septic shock after ICU treatment", Langenbecks Arch Surg, 383(1), pp.44~48 (1998)
- Chung KK, "Evolution of burn resuscitation in operation Iraqi freedom", J Burn Care Research, 27(5), pp.606~611 (2006)
- Hollenberg SM, "Cardiogenic shock", Ann Intern Med, 131(1), pp.47~59 (1999)
- Wiggers CJ, "Physiology of shock", pp.423~440 (1950), Commonwealth Fund
- Brown AF, "Anaphylactic shock : mechanisms and treatment", J Accid Emerg Med, 12(2), pp.89~100 (1995)
- Mizock BA, "The multiple organ dysfunction syndrome", Dis Mon, 55(8), pp.476~526 (2009)
- Kobayashi L, "Hypovolemic shock resuscitation", Surg Clinic North Am, 92(6), pp.1403~1423 (2012)
- Halonen KI, "Multiple organ dysfunction associated with severe acute pancreatitis", Crit Care Med, 30(6), pp.1274~1279 (2002)
- Raghunathan K, "Association between the choice of IV crystalloid and in-hospital mortality among critically ill adults with sepsis", Crit Care Med, 42(7), pp.1585~1591 (2014)
- Page MJ, "Updating guidance for reporting systematic reviews : development of the PRISMA 2020statement", J Clin Epidemiol, 134, pp.103~112 (2021)
- Knaus WA, "APACHE II : a severity of disease classification system", Crit Care Med, 13(10), pp.818~829 (1985)
- Le Gall JR, "A new simplified acute physiology score(SAPS II)based on a European", North American multicenter study, 1993, pp.270(24), 2957~2963
- Ferreira FL, "Serial evaluation of the SOFA score to predict outcome in critically ill patients", JAMA, 286(14), pp.1754~1758 (2001)
- Bellomo R, "Acute renal failure -definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group", Crit Care, 8(4), pp.204~212 (2004)
- Lopes JA., "The RIFLE and AKIN classifications for acute kidney injury : a critical and comprehensive review", Clin Kidney J, 6(1), pp.8~14 (2013)
- Khwaja A, "KDIGO clinical practice guidelines for acute kidney injury", Nephron Clin Prac, 120(4), pp.179~184 (2012)
- Turner RM, "The impact of study size on metaanalyses : examination of underpowered studies in Cochrane reviews", PLoS One, 8(3), pp.e59202~ (2013)
- Furlan AD, "2015 Updated Method Guideline for Systematic Reviews in the Cochrane Back and Neck Group", Spine(Phila Pa 1976), 40(21), pp.1660~1673 (2015)
- Semler MW, "Balanced crystalloids versus saline in the intensive care unit. The SALT randomized trial", Am J Respir Crit Care Med, 195(10), pp.1362~1372 (2017)
- Kumar S, "0.9% Saline v", s Ringer's Lactate for fluid resuscitation in adult sepsis patients in emergency medical services: An open label Randomized Controlled trial, 2020, pp.68(1), 87~
- Verma B, "A multicentre, randomised controlled pilot study of fluid resuscitation with saline or Plasma-Lyte 148 in critically ill patients", Crit Care Resusc, 18(3), pp.205~212 (2016)
- Wu BU, "Lactated Ringer’s solution reduces systemic inflammation compared with saline in patients with acute pancreatitis", Clin Gastroenterol Hepatol, 9(8), pp.710~717 (2011)
- Aboelsoud MM, "Fluid choice matters in critically-ill patients with acute pancreatitis:Lactated ringer’s vs. isotonic saline", R I Med J, 99(10), pp.39~42 (2016)
- Young P, "Effect of a buffered crystalloid solution vs saline on acute kidney injury among patients in the intensive care unit : the SPLIT randomized clinical trial", JAMA, 314(16), pp.1701~1710 (2015)
- Shaw AD, "Impact of intravenous fluid composition on outcomes in patients with systemic inflammatory response syndrome", Crit Care, 19(1), pp.334~343 (2015)
- Jackson KE, "Effect of early balanced crystalloids before ICU admission on sepsis outcomes", Chest, 159(2), pp.585~595 (2021)
- Zampieri FG, "Effect of intravenous fluid treatment with a balanced solution vs 0.9% saline solution on mortality in critically ill patients: The BaSICS randomized clinical trial", JAMA, 326(9), pp.818~829 (2021)
- Liu C, "Balanced crystalloids versus normal saline for fluid resuscitation in critically ill patients: A systematic review and meta-analysis with trial sequential analysis", Am J Emerg Med, 37(11), pp.2072~2078 (2019)
- Li B, "Resuscitation fluids in septic shock : A network meta-analysis of randomized controlled trials", Shock, 53(6), pp.679~685 (2020)
- Tseng CH, "Resuscitation fluid types in sepsis, surgical, and trauma patients: a systematic review and sequential network meta-analyses", Crit Care, 24(1), pp.693~705 (2020)
- Tseng CH, "Impact of comorbidities on beneficial effect of lactated ringers versus saline in sepsis patients", Front Med, 8, pp.758902~ (2021)
- Wakabayashi Y, "Hyperchloremia in patients with chronic renal failure", Tohoku J Exp Med, 149(2), pp.145~150 (1986)