Universidade de São Paulo (USP), Hospital das Clínicas, Faculdade de Medicina, São Paulo, SP, Brazil; Universidade Federal do Rio Grande do Norte (UFRN), Hospital Universitário Onofre Lopes (HUOL), Natal, RN, Brazil.
Universidade Federal do Rio Grande do Norte (UFRN), Hospital Universitário Onofre Lopes (HUOL), Natal, RN, Brazil.
Braz J Anesthesiol. 2021 Jul-Aug;71(4):421-428. doi: 10.1016/j.bjane.2021.02.052. Epub 2021 Apr 15.
Preeclampsia is a multifactorial condition associated with significant morbidity and mortality. Fluid therapy in these patients is challenging since volume expansion may precipitate pulmonary edema, and fluid restriction may worsen renal function. Furthermore, cardiac impairment may introduce an additional component to the hemodynamic management. This article reviews the repercussions of preeclampsia on renal and cardiovascular systems and the development of pulmonary edema, as well as to discuss fluid management, focusing on the mitigation of adverse outcomes and monitoring alternatives. The literature review was carried out using PubMed, Embase, and Google Scholar databases from May 2019 to March 2020. Papers addressing the subjects of interest were included regardless of the publication language. There is a current trend towards restricting the administration of fluids in women with non-complicated preeclampsia. However, patients with preeclampsia may experience hemorrhagic shock, requiring volume resuscitation. In this case, hemodynamic monitoring is recommended to guide fluid therapy while avoiding complications.
子痫前期是一种多因素疾病，与显著的发病率和死亡率相关。这些患者的液体治疗具有挑战性，因为容量扩张可能会引发肺水肿，而液体限制可能会使肾功能恶化。此外，心脏损伤可能会给血液动力学管理带来额外的因素。本文综述了子痫前期对肾脏和心血管系统的影响以及肺水肿的发生，并讨论了液体管理，重点是减轻不良结局和监测替代方案。文献综述使用了 PubMed、Embase 和 Google Scholar 数据库，检索时间为 2019 年 5 月至 2020 年 3 月。纳入了无论出版语言如何都与感兴趣的主题相关的论文。目前的趋势是限制非复杂性子痫前期妇女的液体摄入。然而，子痫前期患者可能会发生失血性休克，需要容量复苏。在这种情况下，建议进行血流动力学监测以指导液体治疗，同时避免并发症。
