Arya Virendra K
Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Indian J Anaesth. 2012 Sep;56(5):454-62. doi: 10.4103/0019-5049.103960.
Perioperative fluid, electrolyte and blood transfusion therapy for infants and children can be confusing due the numerous opinions, formulas and clinical applications, which can result in a picture that is not practical and is often misleading. Perioperatively, crystalloids, colloids and blood components are required to meet the ongoing losses and for maintaining cardiovascular stability to sustain adequate tissue perfusion. Recently controversies have been raised regarding historically used formulas and practices of glucose containing hypotonic maintenance crystalloid solutions for perioperative fluid therapy in children. Paediatric intraoperative transfusion therapy, particularly the approach to massive blood transfusion (blood loss ≥ one blood volume) can be quite complex because of the unique relationship between the patient's blood volume and the volume of the individual blood product transfused. A meticulous fluid, electrolyte and blood transfusion management is required in paediatric patients perioperatively because of an extremely limited margin for error. This article reviews the basic concepts in perioperative fluid and blood transfusion therapy for paediatric patients, along with recent recommendations. For this review, Pubmed, Ovid MEDLINE, HINARI and Google scholar were searched without date restrictions. Search terms included the following in various combinations: Perioperative, fluid therapy, paediatrics, blood transfusion, electrolyte disturbances and guidelines. Only articles with English translation were used.
由于存在众多观点、公式和临床应用，婴幼儿围手术期的液体、电解质和输血治疗可能会令人困惑，这可能导致一种不实用且常常具有误导性的情况。在围手术期，需要晶体液、胶体液和血液成分来弥补持续的液体丢失，并维持心血管稳定性以确保足够的组织灌注。最近，对于儿童围手术期液体治疗中历史上使用的含葡萄糖低渗维持晶体液配方和做法引发了争议。儿科术中输血治疗，尤其是大量输血（失血≥一个血容量）的处理方法可能相当复杂，因为患者血容量与输注的单个血液制品体积之间存在独特关系。由于儿科患者围手术期的误差 margin 极其有限，因此需要精心进行液体、电解质和输血管理。本文回顾了儿科患者围手术期液体和输血治疗的基本概念以及近期建议。为进行此次综述，对 Pubmed、Ovid MEDLINE、HINARI 和谷歌学术进行了无日期限制的搜索。搜索词包括以下各种组合：围手术期、液体治疗、儿科、输血、电解质紊乱和指南。仅使用有英文译文的文章。
