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). 2021 Dec;45(9):552-562. doi: 10.1016/j.medine.2020.10.006.
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.
这篇综述专注于危重症患者的液体管理。该主题基于 10 个单一问题进行讨论,答案经过简化,为临床医生在重症监护病房治疗患者时提供了治疗点所需的基本信息。该综述具有教学目的,既可以作为液体管理的更新,也可以作为危重症新手的入门介绍。人们迫切需要提高对与液体超负荷相关的潜在风险的认识。临床医生不仅要注意给予液体负荷的指征和给予的液体类型,还要注意设定安全限度的重要性。最后,重要的是要实施积极的策略,一旦临床情况被认为稳定且恶化风险较低,就寻求建立负液体平衡。