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静脉输液治疗:基本组成部分及关键注意事项

Intravenous fluid therapy: essential components and key considerations.

作者信息

Silva Catarina, Marcos Pedro

机构信息

Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal.

Department of Gastroenterology, Pêro da Covilhã Hospital, Covilhã, Portugal.

出版信息

Porto Biomed J. 2025 Aug 5;10(4):e296. doi: 10.1097/j.pbj.0000000000000296. eCollection 2025 Sep-Oct.

Abstract

INTRODUCTION

Intravenous (IV) fluid therapy plays a vital role in modern medical practice, particularly in critical care management. This review aims to summarize the composition, indications, and contraindications of IV fluids, serving as a useful resource for healthcare professionals.

METHODS

Review of the literature published in MEDLINE using PubMed and Web of Science, between 2009 and 2024. Systematic reviews, meta-analyses, expert reviews, and guidelines were preferred for analysis.

RESULTS

IV fluids can be administered for various reasons, including resuscitation, correction of electrolyte imbalances, or more critical cases. They can be divided into 2 categories: crystalloids and colloids. Crystalloids, in turn, can be subdivided into unbalanced solutions, such as salines (0.45%, 0.9%, 3%, and 20%) and dextrose 5%, or balanced solutions, such as Ringer lactate and polyelectrolytic solutions. Colloids can be derived from plasma, such as 5% albumin, or semisynthetic, such as 4% modified fluid gelatin. Crystalloids are generally more cost-effective, have a lower risk of allergic reactions, and are more readily available than colloids. However, the use of each solution should be individualized based on the patient's specific needs and corresponding conditions.

CONCLUSIONS

It is essential to have a thorough understanding of available IV fluid solutions to select the best option for each patient's condition at any given time. This review summarizes the most relevant information to guide these decisions. Future research should develop IV fluids that combine the benefits of colloids and crystalloids for safer, more personalized, and cost-effective treatments.

摘要

引言

静脉输液疗法在现代医学实践中起着至关重要的作用,尤其是在重症监护管理方面。本综述旨在总结静脉输液的成分、适应证和禁忌证,为医护人员提供有用的参考资料。

方法

回顾2009年至2024年间发表在MEDLINE上的文献,使用PubMed和Web of Science进行检索。分析时优先选择系统评价、荟萃分析、专家评论和指南。

结果

静脉输液可因多种原因使用,包括复苏、纠正电解质失衡或用于更危急的情况。它们可分为两类:晶体液和胶体液。晶体液又可细分为非平衡溶液,如生理盐水(0.45%、0.9%、3%和20%)和5%葡萄糖溶液,或平衡溶液,如乳酸林格液和多电解质溶液。胶体液可来源于血浆,如5%白蛋白,或半合成品,如4%改性液体明胶。晶体液通常更具成本效益,过敏反应风险较低,且比胶体液更容易获得。然而,每种溶液的使用应根据患者的具体需求和相应情况进行个体化选择。

结论

必须全面了解现有的静脉输液溶液,以便在任何给定时间为每个患者的病情选择最佳方案。本综述总结了最相关的信息以指导这些决策。未来的研究应开发出结合胶体液和晶体液优点的静脉输液,以实现更安全、更个性化且更具成本效益的治疗。

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Intravenous fluid therapy: essential components and key considerations.静脉输液治疗:基本组成部分及关键注意事项
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