Department of Emergency Medicine, Henry Ford Hospital, Wayne State University, Detroit, Michigan, USA.
Curr Opin Crit Care. 2010 Aug;16(4):297-308. doi: 10.1097/MCC.0b013e32833be8b3.
To examine the role of fluid therapy in the pathogenesis of severe sepsis and septic shock. The type, composition, titration, management strategies and complications of fluid administration will be examined in respect to outcomes.
Fluids have a critical role in the pathogenesis and treatment of early resuscitation of severe sepsis and septic shock.
Although this pathogenesis is evolving, early titrated fluid administration modulates inflammation, improves microvascular perfusion, impacts organ function and outcome. Fluid administration has limited impact on tissue perfusion during the later stages of sepsis and excess fluid is deleterious to outcome. The type of fluid solution does not seem to influence these observations.
探讨液体疗法在严重脓毒症和感染性休克发病机制中的作用。本文将从预后角度探讨液体的输注类型、组成、滴定、管理策略和并发症。
液体在严重脓毒症和感染性休克早期复苏的发病机制和治疗中具有关键作用。
尽管这一发病机制正在不断发展，但早期滴定的液体管理可调节炎症、改善微血管灌注、影响器官功能和预后。在脓毒症的后期阶段，液体的输入对组织灌注的影响有限，过多的液体对预后有害。液体溶液的类型似乎并不影响这些观察结果。
