医药卫生羟乙基淀粉 vs 晶体液治疗脓毒血症和感染性休克患者德国 SepNet VISEP 试验结果英文ppt课件.pptVIP

3,170 ml HES 16,905 ml non-HES fluids = 1 5.3 VISEP Trial (HES vs. Ringers´ Lactate)  - Ratio of HES to non-HES fluids in the HES group (days 0-4) - Hemodynamic effects Mean arterial pressure Central venous pressure Central venous oxygen saturation 100 75 50 0 % of patients reaching composite goals 25 VISEP Trial (HES vs. Ringers´ Lactate)  - Results IV: Hemodynamic goals (CVP, MAP, ScvO2) - 24.1% 26.7% 0% 25% 50% 75% 28-day mortality Mortality (%) n=274 n=262 Ringers´ lactate HES p=0.48 VISEP Trial (HES vs. Ringers´ Lactate)  - Results V: Mortality - Ringers´ lactate n=274 p=0.14 HES n=261 VISEP Trial (HES vs. Ringers´ Lactate)  - Results VI: Survival - Effects on renal function VISEP Trial (HES vs. Ringers´ Lactate)  - Start of intervention - Diuresis Days 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 5000 4500 4000 3500 3000 2500 2000 1500 1000 500 0 ml Creatinine Mean SOFA Score 7.53 Mean Ringers` lactate n = 274 3.62 SD 6.75 Median 8.0 Mean HES n = 262 4.05 SD 7.29 Median 0.8 p VISEP Trial (HES vs. Ringers´ Lactate)  - Results VII: Morbidity - VISEP Trial (HES vs. Ringers´ Lactate)  - Results VIII: Morbidity - Days 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 10000 9000 8000 7000 6000 5000 4000 3000 2000 1000 0 HES group VISEP Trial (HES vs. Ringers´ Lactate)  - Total fluids (ml) - Ringers´lactate attributable amounts of HES 236 185 149 124 109 114 93 93 80 82 75 67 68 66 53 56 47 48 48 33 34 * Pat. receiving HES N=* VISEP: RRT and cumulative dose of HES or Ringer’s lactate by various dosage groups P=0.007 between HES doses P=0.345 between Ringer‘s lactate doses VISEP Trial (HES vs. Ringers´ Lactate)  - HES 22 ml/kg/BW