Licari Elisa, Calzavacca Paolo, Ronco Claudio, Bellomo Rinaldo
Department of Intensive Care, Austin Hospital, Melbourne, Vic., Australia.
Contrib Nephrol. 2007;156:167-77. doi: 10.1159/000102080.
Acute kidney injury (AKI) is a common complication of severe sepsis. Severe sepsis is the most common cause of AKI in ICU. The widely accepted and practiced initial cornerstone of treatment for septic AKI is fluid resuscitation. The biological rationale for fluid resuscitation in septic AKI is based on the assumption that septic AKI is an ischemic form of AKI and that increasing renal perfusion and oxygen delivery by means of fluid resuscitation will protect the kidney. Whether this is true, however, remains uncertain. In this paper, we discuss salient pathophysiological aspects of AKI, review the evidence available on the need for fluid resuscitation, the amount and the type of fluid that might be best suited to AKI and discuss all major aspects of fluid resuscitation for septic AKI in humans and experimental animals.
急性肾损伤（AKI）是严重脓毒症的常见并发症。严重脓毒症是重症监护病房（ICU）中AKI最常见的病因。脓毒症性AKI治疗广泛接受且常用的初始基石是液体复苏。脓毒症性AKI进行液体复苏的生物学原理基于这样的假设，即脓毒症性AKI是AKI的一种缺血形式，通过液体复苏增加肾灌注和氧输送将保护肾脏。然而，这是否属实仍不确定。在本文中，我们讨论了AKI的显著病理生理学方面，回顾了关于液体复苏必要性、可能最适合AKI的液体量和类型的现有证据，并讨论了人类和实验动物脓毒症性AKI液体复苏的所有主要方面。
