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小动物容量状态和液体反应性的评估

Assessment of Volume Status and Fluid Responsiveness in Small Animals.

作者信息

Boysen Søren R, Gommeren Kris

机构信息

Department of Veterinary Clinical and Diagnostic Sciences, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada.

Department of Companion Animals, Faculty of Veterinary Medicine, University of Liège, Liège, Belgium.

出版信息

Front Vet Sci. 2021 May 28;8:630643. doi: 10.3389/fvets.2021.630643. eCollection 2021.

Abstract

Intravenous fluids are an essential component of shock management in human and veterinary emergency and critical care to increase cardiac output and improve tissue perfusion. Unfortunately, there are very few evidence-based guidelines to help direct fluid therapy in the clinical setting. Giving insufficient fluids and/or administering fluids too slowly to hypotensive patients with hypovolemia can contribute to continued hypoperfusion and increased morbidity and mortality. Similarly, giving excessive fluids to a volume unresponsive patient can contribute to volume overload and can equally increase morbidity and mortality. Therefore, assessing a patient's volume status and fluid responsiveness, and monitoring patient's response to fluid administration is critical in maintaining the balance between meeting a patient's fluid needs vs. contributing to complications of volume overload. This article will focus on the physiology behind fluid responsiveness and the methodologies used to estimate volume status and fluid responsiveness in the clinical setting.

摘要

静脉输液是人类和兽医急诊及重症护理中休克管理的重要组成部分,用于增加心输出量和改善组织灌注。不幸的是,在临床环境中,几乎没有基于证据的指南来指导液体治疗。对于低血容量性低血压患者,给予的液体不足和/或输液速度过慢会导致持续的灌注不足,并增加发病率和死亡率。同样,对容量无反应的患者给予过多液体可能导致容量超负荷,同样会增加发病率和死亡率。因此,评估患者的容量状态和液体反应性,并监测患者对液体输注的反应,对于维持满足患者液体需求与导致容量超负荷并发症之间的平衡至关重要。本文将重点关注液体反应性背后的生理学以及在临床环境中用于估计容量状态和液体反应性的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11c9/8193042/3255f2ef85fa/fvets-08-630643-g0001.jpg

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