Sanfilippo F, Messina A, Cecconi M, Astuto M
Department of Anaesthesia and Intensive Care, A.O.U. "Policlinico-Vittorio Emanuele", Catania, Italy.
Humanitas Clinical and Research Center - IRCCS, Milano, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, MI, Italy.
Med Intensiva (Engl Ed). 2020 Dec 12. doi: 10.1016/j.medin.2020.10.005.
This review focuses on fluid management of critically ill patients. The topic is addressed based on 10 single questions with simplified answers that provide clinicians with the basic information needed at the point of care in treating patients in the Intensive Care Unit. The review has didactic purposes and may serve both as an update on fluid management and as an introduction to the subject for novices in critical care. There is an urgent need to increase awareness regarding the potential risks associated with fluid overload. Clinicians should be mindful not only of the indications for administering fluid loads and of the type of fluids administered, but also of the importance to set safety limits. Lastly, it is important to implement proactive strategies seeking to establish negative fluid balance as soon as the clinical conditions are considered to be stable and the risk of deterioration is low.
本综述聚焦于危重症患者的液体管理。该主题基于10个简单问题进行阐述并给出简化答案，为临床医生在重症监护病房治疗患者时提供即时所需的基本信息。本综述具有教学目的，既可以作为液体管理的最新知识，也可作为危重症新手对该主题的入门介绍。迫切需要提高对液体超负荷相关潜在风险的认识。临床医生不仅应留意给予液体负荷的指征和所给予液体的类型，还应重视设定安全限度的重要性。最后，重要的是实施积极策略，一旦临床状况被认为稳定且恶化风险较低，就寻求建立负液体平衡。
