{"id":20460,"date":"2021-08-15T06:04:00","date_gmt":"2021-08-14T22:04:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=20460"},"modified":"2021-08-15T06:53:04","modified_gmt":"2021-08-14T22:53:04","slug":"jama%e5%9c%a8%e7%ba%bf%e5%8f%91%e8%a1%a8%ef%bc%9a%e8%be%83%e6%85%a2%e4%b8%8e%e8%be%83%e5%bf%ab%e9%9d%99%e8%84%89%e8%be%93%e6%b6%b2%e9%80%9f%e5%ba%a6%e5%af%b9%e5%8d%b1%e9%87%8d%e7%97%85%e6%82%a3","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=20460","title":{"rendered":"[JAMA\u5728\u7ebf\u53d1\u8868]\uff1a\u8f83\u6162\u4e0e\u8f83\u5feb\u9759\u8109\u8f93\u6db2\u901f\u5ea6\u5bf9\u5371\u91cd\u75c5\u60a3\u8005\u75c5\u6b7b\u7387\u7684\u5f71\u54cd"},"content":{"rendered":"\n

Original Investigation August 10, 2021<\/p>\n\n\n\n

Effect of Slower vs Faster Intravenous Fluid Bolus Rates on Mortality in Critically Ill Patients: The BaSICS Randomized Clinical Trial<\/h1>\n\n\n\n

Fernando G.\u00a0Zampieri,\u00a0Fl\u00e1via R.\u00a0Machado,\u00a0Rodrigo S.\u00a0Biondi,\u00a0et al<\/h3>\n\n\n\n

JAMA.\u00a0<\/em>Published online August 10, 2021. doi:10.1001\/jama.2021.11444<\/h3>\n\n\n\n

Abstract<\/p>\n\n\n\n

Importance<\/strong>  Slower intravenous fluid infusion rates could reduce the formation of tissue edema and organ dysfunction in critically ill patients; however, there are no data to support different infusion rates during fluid challenges for important outcomes such as mortality.<\/p>\n\n\n\n

Objective<\/strong>  To determine the effect of a slower infusion rate vs control infusion rate on 90-day survival in patients in the intensive care unit (ICU).<\/p>\n\n\n\n

Design, Setting, and Participants<\/strong>  Unblinded randomized factorial clinical trial in 75 ICUs in Brazil, involving 11\u202f052 patients requiring at least 1 fluid challenge and with 1 risk factor for worse outcomes were randomized from May 29, 2017, to March 2, 2020. Follow-up was concluded on October 29, 2020. Patients were randomized to 2 different infusion rates (reported in this article) and 2 different fluid types (balanced fluids or saline, reported separately).<\/p>\n\n\n\n

Interventions<\/strong>  Patients were randomized to receive fluid challenges at 2 different infusion rates; 5538 to the slower rate (333 mL\/h) and 5514 to the control group (999 mL\/h). Patients were also randomized to receive balanced solution or 0.9% saline using a factorial design.<\/p>\n\n\n\n

Main Outcomes and Measures<\/strong>  The primary end point was 90-day survival.<\/p>\n\n\n\n

Results<\/strong>  Of all randomized patients, 10\u202f520 (95.2%) were analyzed (mean age, 61.1 years [SD, 17.0 years]; 44.2% were women) after excluding duplicates and consent withdrawals. Patients assigned to the slower rate received a mean of 1162 mL on the first day vs 1252 mL for the control group. By day 90, 1406 of 5276 patients (26.6%) in the slower rate group had died vs 1414 of 5244 (27.0%) in the control group (adjusted hazard ratio, 1.03; 95% CI, 0.96-1.11; P<\/em>\u2009=\u2009.46). There was no significant interaction between fluid type and infusion rate (P<\/em>\u2009=\u2009.98).<\/p>\n\n\n\n

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Conclusions and Relevance<\/strong>  Among patients in the intensive care unit requiring fluid challenges, infusing at a slower rate compared with a faster rate did not reduce 90-day mortality. These findings do not support the use of a slower infusion rate.<\/p>\n\n\n\n

Trial Registration<\/strong>  ClinicalTrials.gov Identifier: NCT02875873<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

Original Investigation August 10, 2021 E […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/20460"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=20460"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/20460\/revisions"}],"predecessor-version":[{"id":20461,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/20460\/revisions\/20461"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=20460"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=20460"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=20460"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}