COMPARATIVE EVALUATION OF CLINICAL EFFECTIVENESS OF THE INFUSION THERAPY WITH BALANCED AND UNBALANCED SOLUTIONS IN SEPSIS IN CHILDREN

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Abstract


The purpose of the study was to provide for comparative evaluation of clinical effectiveness of volemic reimbursement in children suffering from sepsis when using balanced and unbalanced infusion media.

Methods. This was a prospective, observational, controlled and single center study. 35 children were included into the development. Depending on the use of basic infusion medium, the children were divided into two groups such as the control group (n=20) with Ringer’s solution and the basic group (n=15) with Sterofunding Isotonic. The tactics of initial infusion therapy and intensive therapy of sepsis was comparable between the two groups. The clinical effectiveness was evaluated based on estimation dynamics using the PELOD scale, inotropic support duration, therapy duration, lethality, and monitoring of physiological variables.

Results. In 24 hours of intensive therapy, PELOD- estimated severity of patients’ conditions is comparable between the groups. Children of the basic group had less frequent signs of acute renal failure, decreased duration of inotropic support and reduced hospital treatment duration.

Conclusion. The use of balanced solutions applied during the infusion therapy of children suffering from sepsis is not associated with the variations in lethality and ALV duration. However, it can reduce the frequency of acute renal failures and inotropic support duration. 


About the authors

P. I. Mironov

Bashkir State Medical University

Author for correspondence.
Email: mironovpi@mail.ru

Russian Federation

Dr.Sci (med), professor, Department of Anaesthesiology and Reanimatology,

Ufa

References

  1. Singer M., Deutschman C. S., Seymour C. W. et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis 3) //JAMA. 2016, 315:- 801–816.
  2. Sümpelmann R., Becke K., Crean P. et al. European consensus statement for intraoperative fluid therapy in children. Eur. J. Anaesthesiol 2011; 28: 637–639.
  3. Perioperative intravenous fluid therapy in children: guidelines from the Assotiation of the Scientific Medical Societies in German // Pediatric Anesthesia 2017. 27: 10–18.
  4. Александрович Ю. С., Воронцова Н. Ю., Гребенников В. А. и др. Рекомендации по проведению инфузионно-трансфузионной терапии у детей во время хирургических операций; www/babyanesthesia.ru. [Aleksandrovich Yu.S., Voroncova N. Yu., Grebennikov V. A. i dr. Rekomendacii po provedeniyu infuzionno-transfuzionnoj terapii u detej vo vremya hirurgicheskih operacij; www/babyanesthesia.ru. (in Russian)]
  5. Raghunathan K., Shaw A., Nathanson B. Association Between the Choice of IV Crystalloid and In-Hospital Mortality Among Critically ill Adults with Sepsis // Crit Care Med 2014; 42:1585–1591.
  6. Samransamruajki R., Saelim K., Hantragoo S. A comparison of NSS vs balanced salt solution as a fluid resuscitation and impact of fluid balance on clinical outcomes in pediatric septic shock // Crit Care Shock (2017) 20:68–7.
  7. Myburgh J., McIntyre L. New insights into fluid resuscitation // Intensive Care Med 2013;39:998–1001.
  8. Oliveira C. F., Nogueira de Sá F. R., Oliveira D. S. et al. Time-and Fluid sensitive resuscitation for hemodynamic support of children in septic shock: barriers to the implementation of the American College of Critical Care Medicine/ Pediatric Advanced Life Support Guidelines in a pediatric intensive care unit in a developing world // PediatrEmerg Care 2008;24:810–5.
  9. Long E., Duke T. Fluid resuscitation therapy for paediatric sepsis // J Paediatr Child Health2016;52:141–6.
  10. Schultz M. J. Balancing between benefit andharm-what is the best solution in fluid resuscitation? // Crit Care Med 2015;43: e26–7.
  11. Myburgh J. A., Mythen M. G. Resuscitation Fluids // N Engl J Med 2013;369:2462–3.
  12. Handy J. M., Soni N. Physiological effects of hyperchloraemia and acidosis // Br J Anaesth. 2008;101:141–50.
  13. Madhusudan P., Tirupakuzhi Vijayaraghavan B. K., Cove M. E. Fluid resuscitation in sepsis: Reexamining the paradigm // Biomed Res Int 2014;2014: 984082.
  14. Marik P., Bellomo R. A rational approach to fluid therapy in sepsis // Br J Anaesth 2016;116: 339–49.
  15. Dellinger R. P. Crystalloids for fluid resuscitation in sepsis: where is the balance? // Ann Intern Med 2014;161:372–3.
  16. Shaw A. D., Raghunathan K., Peyerl F. W., Munson S. H., Paluszkiewicz S. M., Schermer C. R. Association between intravenous chloride load during resuscitation and in-hospital mortality among patients with SIRS // Intensive Care Med 2014;40:1897–905.

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