Libert N, de Rudnicki S, Cirodde A, Thépenier C, Mion G
Service de réanimation, hôpital d'instruction de armées du Val-de-Grâce, 74, boulevard de Port-Royal, 75005 Paris, France.
Ann Fr Anesth Reanim. 2010 Jan;29(1):25-35. doi: 10.1016/j.annfar.2009.10.018. Epub 2010 Jan 21.
Fluid loading is the first step, necessary to care for severe sepsis. Two main classes of solutions are currently available: crystalloids and colloids. The concept of small volume resuscitation with hypertonic saline has emerged these last years in the care of traumatic haemorrhagic shock. The main benefits are the restoration of intravascular volume, improvement of cardiac output and improvement of regional circulations. Many experiments highlight modulation of immune and inflammatory cascades. We report the mechanisms of action of hypertonic saline based on experimental human and animal studies, which advocate its use in septic shock.
液体复苏是治疗严重脓毒症的首要步骤。目前有两大类溶液可供使用：晶体液和胶体液。近年来，高渗盐水小容量复苏的概念已出现在创伤性失血性休克的治疗中。其主要益处包括恢复血管内容量、改善心输出量以及改善局部循环。许多实验强调了对免疫和炎症级联反应的调节作用。我们根据人体和动物实验研究报告了高渗盐水的作用机制，这些研究支持在感染性休克中使用高渗盐水。
