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Báo cáo y học: "Pro/con clinical debate: Do colloids have advantages over crystalloids in paediatric sepsi"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Pro/con clinical debate: Do colloids have advantages over crystalloids in paediatric sepsis? | Critical Care August 2002 Vol 6 No 4 Khandelwal et al. Commentary Pro con clinical debate Do colloids have advantages over crystalloids in paediatric sepsis Puran Khandelwal1 Desmond Bohn2 Joseph A Carcillo3 and Neal J Thomas4 1Clinical Fellow Department of Critical Care Medicine The Hospital for Sick Children Toronto Ontario Canada 2Chief Department of Critical Care Medicine The Hospital for Sick Children Toronto Ontario Canada 3Associate Professor Department of Pediatrics Anesthesiology and Critical Care Medicine Children s Hospital of Pittsburgh Pennsylvania USA 4Assistant Professor Department of Pediatrics Division of Pediatric Critical Care Medicine Penn State Children s Hospital Pennsylvania USA Correspondence Critical Care Forum editorial office editorial@ccforum.com Published online 27 May 2002 Critical Care 2002 6 286-288 This article is online at http ccforum.com content 6 4 286 2002 BioMed Central Ltd Print ISSN 1364-8535 Online ISSN 1466-609X Abstract Despite decades of resuscitating patients with intravenous fluids in intensive care units it is somewhat surprising that very little consensus exists regarding the type of fluid physicians should choose. Factors that influence decisions are often local culture or politics hospital administrators history i.e. I ve always done it this way and budgets as opposed to strong evidence. In the present issue of Critical Care we are presented with compelling arguments for and against the administration of colloids as opposed to crystalloids in paediatric sepsis. One point that appears to be clear is that the ideal choice of intravenous fluid goes beyond the simple haemodynamic effect. As such in the future clinicians will need to consider other factors when making their decision. In addition large-scale quality randomised studies are desperately needed to guide clinicians. Keywords crystalloids colloids sepsis The scenario A 5-year-old girl is admitted to the paediatric intensive care unit with meningococcal sepsis.