{"id":29066,"date":"2025-10-11T04:11:00","date_gmt":"2025-10-10T20:11:00","guid":{"rendered":"https:\/\/csccm.org.cn\/?p=29066"},"modified":"2025-10-12T08:17:10","modified_gmt":"2025-10-12T00:17:10","slug":"29066","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=29066","title":{"rendered":"[Chest\u53d1\u8868\u8bba\u6587]\uff1a\u91cd\u75c7\u60a3\u8005\u7684\u5e73\u8861\u76d0\u6eb6\u6db2"},"content":{"rendered":"\n<p><strong>CRITICAL CARE: ORIGINAL RESEARCH<\/strong><\/p>\n\n\n\n<h1 class=\"wp-block-heading\">Normosol-R vs Lactated Ringers in the Critically Ill: A Randomized Trial<\/h1>\n\n\n\n<h3 class=\"wp-block-heading\">Edward T.\u00a0Qian,\u00a0Ryan M.\u00a0Brown,\u00a0Karen E.\u00a0Jackson,\u00a0et al<\/h3>\n\n\n\n<h3 class=\"wp-block-heading\">Chest 2025; 168: 336-345<\/h3>\n\n\n\n<h2 class=\"wp-block-heading\">Abstract<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">Background<\/h3>\n\n\n\n<p>Balanced crystalloid solutions may improve clinical outcomes compared with saline for some critically ill adults, but it is unclear whether differences in composition between balanced crystalloid solutions affect outcomes.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Research Question<\/h3>\n\n\n\n<p>Does the choice of balanced crystalloid solutions (Normosol-R vs lactated Ringers) impact acid-base status, organ function, or outcomes for critically ill adults?<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Study Design and Methods<\/h3>\n\n\n\n<p>This pragmatic, cluster-randomized, multiple-crossover trial at an academic medical center in the United States compared the use of Normosol-R vs lactated Ringers among critically ill adults. The primary outcome was the plasma bicarbonate (HCO<sub>3<\/sub><sup>\u2212<\/sup>) concentration between enrollment and 7 days. Secondary outcomes included receipt of kidney replacement therapy and death by day 30.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Results<\/h3>\n\n\n\n<p>Between June 1, 2018, and January 31, 2019, 2,084 patients were enrolled. The median age was 59 years, 1,006 patients (48.3%) were female, and the median Sequential Organ Failure Assessment score was 5 (interquartile range, 3-8). HCO<sub>3<\/sub><sup>\u2212<\/sup>\u00a0concentration between enrollment and 7 days did not differ between the Normosol-R and lactated Ringers groups (mean difference, \u22120.12 mmol\/dL; 95% CI, \u22120.61 to 0.36;\u00a0<em>P<\/em>\u00a0= .61). A total of 58 patients (6.0%) in the Normosol-R group and 47 patients (5.0%) in the lactated Ringers group received new kidney replacement therapy (absolute risk difference, 1.0%; 95% CI, \u22121.2% to 3.1%). Death by day 30 occurred in 172 patients (16.3%) in the Normosol-R group and 164 patients (16.0%) in the lactated Ringers group (absolute risk difference, 0.3%; 95% CI, \u22122.9% to 3.6%).<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/ars.els-cdn.com\/content\/image\/1-s2.0-S0012369225001655-ga1_lrg.jpg\" alt=\"\"\/><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/ars.els-cdn.com\/content\/image\/1-s2.0-S0012369225001655-gr1_lrg.jpg\" alt=\"\"\/><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/ars.els-cdn.com\/content\/image\/1-s2.0-S0012369225001655-gr2_lrg.jpg\" alt=\"\"\/><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/ars.els-cdn.com\/content\/image\/1-s2.0-S0012369225001655-gr3_lrg.jpg\" alt=\"\"\/><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\">Interpretation<\/h3>\n\n\n\n<p>Among critically ill adults, the use of Normosol-R for IV fluid therapy did not affect plasma HCO<sub>3<\/sub><sup>\u2212<\/sup>&nbsp;concentrations or clinical outcomes compared with lactated Ringers.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Clinical Trial Registration<\/h3>\n\n\n\n<p><a href=\"http:\/\/clinicaltrials.gov\/\" target=\"_blank\" rel=\"noreferrer noopener\">ClinicalTrials.gov<\/a>; No.: NCT03537898; URL:&nbsp;<a href=\"http:\/\/www.clinicaltrials.gov\/\" target=\"_blank\" rel=\"noreferrer noopener\">www.clinicaltrials.gov<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>CRITICAL CARE: ORIGINAL RESEARCH Normosol-R vs Lactated [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/29066"}],"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=29066"}],"version-history":[{"count":2,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/29066\/revisions"}],"predecessor-version":[{"id":29068,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/29066\/revisions\/29068"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=29066"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=29066"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=29066"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}