Clinical efficacy of fluid resuscitation with 75 g/L NaCi solution in traumatic hypovolemic shock:a Meta-analysis of randomized controlled trials / 中华创伤杂志

ABSTRACT

Objective To investigate the efficacy and safety of fluid resuscitation with 75 g/L NaCl solution in traumatic hypovolemic shock using Meta-analysis. Methods Based on the inclusion criteria,the randomized controlled trials (RCTs) were identified by retrieving the databases including PUBMED,EMBASE,OVID,Cochrane library and EBSCO.The quality of studies was also evaluated.Indices including systolic blood pressure,hemoglobin,serum Na level and mortality were extracted from the enrolled RTCs and were comparatively analyzed between the 75 g/L NaCl group and the isotonic saline group for evaluating the safety and efficacy of 75 g/L NaCI solution.The extracted data were analyzed by using the Review Manager 5.0.25. Results Six RCTs were eligible for Meta-analysis.The 75 g/L NaCl group displayed remarkable increase in systolic blood pressure and decrease in hemoglobin level,compared with the isotonic saline group ( MD =6.23,95％ CI 2.78-9.69,P ＜ 0.01 ; MD =-6.11,95％CI -8.25-3.96,P ＜ 0.01,respectively).Short-term hyperosmolar state in 75 g/L NaCl group was increased significantly but was considered acceptable ( MD =7.97,95％ CI 7.55-8.38,P ＜ 0.01 ).No significant difference in mortality was found between 75 g/L NaCl group and isotonic saline group ( RR =0.96,95％ CI 0.84-1.10,P ＞ 0.05). Conclusion Fluid resuscitation with 75 g/L NaCl solution is safe and effective for traumatic hypovolemic shock.