Lewis F R
J Trauma. 1986 Sep;26(9):804-11. doi: 10.1097/00005373-198609000-00005.
A computer model incorporating known behavior of the cardiovascular system and intravascular:interstitial fluid exchange was designed which allowed bleeding rate, IV infusion rate, and prehospital care times to be independently specified. All possible circumstances were examined. The model shows that IV's are potentially of benefit only when all of the following occur: 1) the bleeding rate is initially 25-100 ml/min, 2) the prehospital time exceeds 30 minutes, and 3) the IV infusion rate is approximately equal to the bleeding rate. IV infusions therefore appear of little benefit in the usual urban environment and have a sharply limited role overall. The possibility of pulmonary edema from fluid overload in nonhypovolemic patients, and reluctance of field personnel to infuse fluid at the rates necessary to produce benefit raise further questions about realistic benefit of IV's in all but the most rural systems.
设计了一种计算机模型，该模型纳入了心血管系统的已知行为以及血管内与组织间液的交换情况，从而能够独立设定出血速率、静脉输液速率和院前护理时间。研究了所有可能的情况。该模型表明，只有在以下所有情况同时出现时，静脉输液才可能有益：1）初始出血速率为25 - 100毫升/分钟；2）院前时间超过30分钟；3）静脉输液速率大致等于出血速率。因此，在通常的城市环境中，静脉输液似乎益处不大，总体作用极为有限。非低血容量患者因液体过载导致肺水肿的可能性，以及现场人员不愿以产生益处所需的速率输注液体，这进一步引发了关于静脉输液在除最偏远地区系统之外的实际益处的质疑。
