Malbrain Manu L N G, Caironi Pietro, Hahn Robert G, Llau Juan V, McDougall Marcia, Patrão Luís, Ridley Emily, Timmins Alan
First Department Anaesthesiology and Intensive Therapy, Medical University Lublin, Lublin, Poland.
International Fluid Academy, Lovenjoel, Belgium.
Ann Intensive Care. 2023 Sep 25;13(1):89. doi: 10.1186/s13613-023-01177-y.
Although effective and appropriate fluid management is a critical aspect of quality care during hospitalization, the widespread adoption of consistent policies that ensure adequate fluid stewardship has been slow and heterogenous. Despite evidence-based guidelines on fluid management being available, clinical opinions continue to diverge on important aspects of care in this setting, and the consistency of guideline implementation is far from ideal. A multidisciplinary panel of leading practitioners and experts convened to discuss best practices for ongoing staff education, intravenous fluid therapy, new training technologies, and strategies to track the success of institutional fluid stewardship efforts. Fluid leads should be identified in every hospital to ensure consistency in fluid administration and monitoring. In this article, strategies to communicate the importance of effective fluid stewardship for the purposes of education, training, institutional support, and improvement of patient outcomes are reviewed and recommendations are summarized.
尽管有效的、恰当的液体管理是住院期间优质护理的关键环节,但确保充分液体管理的一致政策的广泛采用一直进展缓慢且参差不齐。尽管有基于证据的液体管理指南,但在此背景下,临床意见在护理的重要方面仍存在分歧,且指南实施的一致性远不理想。一个由主要从业者和专家组成的多学科小组召开会议,讨论持续员工教育、静脉输液治疗、新培训技术以及跟踪机构液体管理工作成效的策略等最佳实践。每家医院都应确定液体管理负责人,以确保液体给药和监测的一致性。本文回顾了为教育、培训、机构支持及改善患者结局而传达有效液体管理重要性的策略,并总结了相关建议。