Waydhas C
Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Essen, Hufelandstr. 55, 45147, Essen, Deutschland,
Med Klin Intensivmed Notfmed. 2015 Apr;110(2):118-21. doi: 10.1007/s00063-015-0003-5. Epub 2015 Mar 26.
Fluid therapy is daily routine in the perioperative setting; however, high quality guidelines are lacking. The S3-guideline Intravasal Fluid Therapy in the Adult Patient gives evidence- and consensus-based recommendations for the use of fluids in perioperative and critically ill patients. In addition to identifying hypovolemia and guiding volume replacement, the type of fluid that should be used is addressed.
The purpose of this article is to present and discuss the recommendations of the S3-guideline with respect to the choice of crystalloids in the perioperative setting.
A literature search within the scope of the guideline development was performed.
In this review the recommendations and their rationale in the perioperative setting are presented. Crystalloids are the basis of fluid therapy. Instead of isotonic saline, buffered solutions are recommended. Regarding the type of buffer (lactate, acetate, malate), no preferences based on outcome data can be made.
液体治疗是围手术期的日常操作;然而,缺乏高质量的指南。S3 指南《成年患者血管内液体治疗》为围手术期和危重症患者使用液体提供了基于证据和共识的建议。除了识别血容量不足和指导容量补充外,还涉及了应使用的液体类型。
本文旨在介绍和讨论 S3 指南关于围手术期晶体液选择的建议。
在指南制定范围内进行了文献检索。
本综述介绍了围手术期的建议及其理论依据。晶体液是液体治疗的基础。推荐使用缓冲溶液而非等渗盐水。关于缓冲剂的类型(乳酸盐、醋酸盐、苹果酸盐),基于结果数据无法做出偏好选择。