Moen H
Intensivavdelingen, Kirurgisk klinikk, Ullevål sykehus, Oslo.
Tidsskr Nor Laegeforen. 1992 Mar 10;112(7):901-4.
Circulatory failure is the most dominating problem in the multitraumatized patient in hospital. This article describes the most important pathophysiological events from a compensated stage to the final irreversible stage. The practical consequences for both the doctor and the patient are the amount of bleeding and the duration of the stage of shock. When there are technical problems with venous access we recommend surgical cut-down of peripheral veins. The article also describes the principal quality of the most commonly used volume substitutes. Finally, the author discusses the use of sodium bicarbonate in the event of lactacidosis.
循环衰竭是医院中多发伤患者最主要的问题。本文描述了从代偿期到最终不可逆阶段最重要的病理生理过程。对医生和患者而言,实际的影响因素是出血量和休克阶段的持续时间。当静脉通路存在技术问题时,我们建议进行外周静脉切开术。本文还描述了最常用的容量替代液的主要性质。最后,作者讨论了在乳酸酸中毒情况下碳酸氢钠的使用。