The safety and efficacy of fluid resuscitation with hypertonic saline in traumatic hypovolemic shock:a meta-analysis
10.3760/cma.j.issn.1008-1372.2018.05.012
- VernacularTitle:高渗氯化钠溶液复苏创伤失血性休克安全性及有效性的Meta分析
- Author:
Lei YANG
1
;
Xiaolan KANG
;
Jiasheng WANG
;
Tieyi HU
Author Information
1. 402360,重庆市大足区人民医院检验科
- Keywords:
Saline solution,hypertonic/TU;
Shock,traumatic/DT;
Resuscitation/MT;
Meta-analysis
- From:
Journal of Chinese Physician
2018;20(5):684-688,692
- CountryChina
- Language:Chinese
-
Abstract:
Objective To assess the safety and efficacy of hypertonic saline in traumatic hypovolemic shock with Meta-analysis.Methods Comprehensive electronic search strategies were developed using the following electronic databases:PubMed,EMBASE,Medline,Ovid、Clinical Trials,CNKI,Wan Fang,CBM and FMJS.The Literature published before August of 2017 was searched.The randomized controlled trials (RCTs) about hypertonic saline in traumatic hypovolemic shock were included.A data-extraction sheet was developed based on the preset standards.The data from eligible studies were pooled through Meta-analysis.Results 9 trials with a total of 1600 patients (741cases in observation group,859 cases in control group) met the inclusion criteria.The meta-analysis showed that the hypertonic saline group displayed remarkable increase in the systolic blood pressure and decrease in hemoglobin level,compared with the isotonic saline group [MD =6.43,95％ CI(1.16,11.70),P ＜0.05],[MD =-5.99,95％ CI (-9.04,-2.95),P ＜0.05].The level of serum sodium [MD =7.94,95％ CI(7.39,8.50),P ＜0.05],serum chloride [MD =9.67,95 ％ CI(8.77,10.57),P ＜ 0.05] and osmolality [MD =18.11,95％ CI (10.73,25.49),P ＜ 0.05] in the hypertonic saline group was increased significantly but acceptable.No significant difference in mortality was found between the hypertonic saline group and the isotonic saline group [OR =0.88,95％ CI(0.69,1.11),P ＞ 0.05].Conclusions Available evidence shows that small volume hypertonic Sodium Chloride saline is safe and effective for resuscitation in patients with traumatic hemorrhagic shock.Since the quality of the inclued studes were not high,more high-quality,multicenter randomized controlled clinical studies need to provide better evidence for the above conclusion.
