Department of Anesthesiology, University of North Carolina, Chapel Hill, North Carolina, USA.
Anesth Analg. 2010 Feb 1;110(2):375-90. doi: 10.1213/ANE.0b013e3181b6b3b5. Epub 2009 Dec 2.
It has been more than 50 yr since the landmark article in which Holliday and Segar (Pediatrics 1957;19:823-32) proposed the rate and composition of parenteral maintenance fluids for hospitalized children. Much of our practice of fluid administration in the perioperative period is based on this article. The glucose, electrolyte, and intravascular volume requirements of the pediatric surgical patient may be quite different than the original population described, and consequently, use of traditional hypotonic fluids proposed by Holliday and Segar may cause complications, such as hyperglycemia and hyponatremia, in the postoperative surgical patient. There is significant controversy regarding the choice of isotonic versus hypotonic fluids in the postoperative period. We discuss the origins of perioperative fluid management in children, review the current options for crystalloid fluid management, and present information on colloid use in pediatric patients.
自 Holliday 和 Segar（儿科学 1957；19：823-32）发表具有里程碑意义的文章提出住院儿童肠外维持液的速率和组成以来，已经过去了 50 多年。我们在围手术期进行液体管理的许多做法都是基于这篇文章。儿科手术患者的葡萄糖、电解质和血管内容量需求可能与最初描述的人群有很大不同，因此，使用 Holliday 和 Segar 提出的传统低张液可能会导致术后手术患者出现高血糖和低钠血症等并发症。术后选择等张液还是低张液存在很大争议。我们讨论了儿童围手术期液体管理的起源，回顾了目前晶体液管理的选择，并介绍了儿科患者胶体使用的信息。
