Department of Pharmacy Practice & Science, The University of Arizona, Tucson, AZ, USA.
Department of Pharmacy Practice, College of Pharmacy, Midwestern University, Glendale, AZ, USA.
Ann Pharmacother. 2023 May;57(5):609-616. doi: 10.1177/10600280221125169. Epub 2022 Sep 9.
At least 30 mL/kg of crystalloid fluid administration within the first 3 hours of resuscitation is suggested by the current Surviving Sepsis Campaign guidelines for management of sepsis and septic shock. This commentary discusses the challenges with using a weight-based approach to bolus fluid dosing during the early phase of resuscitation of adult, obese patients. Based on the available literature, arguments can be made for the use of either ideal or adjusted body weight for weight-based fluid dosing, but there are concerns with fluid overload if using actual body weight to dose patients with more severe forms of obesity.
目前，脓毒症和脓毒性休克管理的《拯救脓毒症运动指南》建议，在复苏的头 3 小时内，至少要给予 30 毫升/公斤的晶体液。本评论讨论了在肥胖成人患者复苏的早期阶段，使用基于体重的冲击液剂量方法所面临的挑战。根据现有文献，可以使用理想体重或调整后的体重来进行基于体重的液体剂量，但如果使用实际体重给更严重肥胖形式的患者给药，可能会导致液体超负荷的问题。
