›› 2014, Vol. 32 ›› Issue (1): 70-75.

• Original Article • Previous Articles     Next Articles

The impact of fluid resuscitation on clinical outcome of pediatric septic shock: a meta-analysis LIU Jie1,2, TAO Yexuan2,3, CAI Wei1,2,3 (1.Department of Pediatric Surgery, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine; 2.The Key Laboratory of Pediatric Gastroenterology and Nutrition of Shanghai; 3.Department of Nutrition, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200092, China)

  

  • Received:2013-07-01 Online:2014-01-15 Published:2014-01-15

Abstract:  Objectives To systemically review the evidence from clinical trials comparing the use of crystalloids and colloids for fluid resuscitation in children with septic shock. Methods Medline, SCI, Embase, Cochrane Library, Google scholar and Chinese Biomedicine Database were searched for randomized controlled trials in children ages one month to 15 years with septic shock published between Jan, 2003 and May, 2013. The form or volume of transfusion with crystalloids or colloids was the only difference between the intervention and control groups. Methodological quality assessment was based on the Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.1 and Jadad’s score scale. RevMan 5.0 statistical software was used for meta-analysis. Results In 181 relative articles, 8 trials met the criteria. On fatality rate, 5 trails compared colloids with crystalloids, and the fixed model was applied RR=0.95, 95%CI:0.76~1.19 (P=0.66); 3 trails compared different forms of colloids, and the fixed model was applied RR=0.47, 95%CI :0.14~1.63 (P=0.23); 4 trails compared fluid resuscitation with traditional therapy, after excluded one trail, the fixed model was applied RR=1.44, 95%CI:1.13~1.83 (P=0.003). On complication of pulmonary edema, 2 trails compared colloids with crystalloids, and the random effect model was applied RR=1.11, 95%CI :0.13~9.71 (P=0.93); 4 trails compared fluid resuscitation with traditional therapy, and the random effect model was applied RR=0.83, 95%CI:0.21~3.29 (P=0.79). On 8-hour emergency rescue, 2 trails compared colloids with crystalloids, and the fixed model was applied RR=2.43, 95%CI:0.71~8.36 (P=0.16); 2 trails compared fluid resuscitation with traditional therapy, and the fixed model was applied RR=0.43, 95%CI:0.19~0.97 (P=0.04). Conclusions There is no significant difference between colloids and crystalloids in the effect of fluid resuscitation for children with septic shock.