Fluid Resuscitation in Severe Sepsis

被引:35
作者
Loflin, Rob [1 ]
Winters, Michael E. [2 ]
机构
[1] Univ Rochester, Med Ctr, Rochester, NY 14642 USA
[2] Univ Maryland, Sch Med, Crit Care Program, Internal Med,Emergency Med, 110 South Paca St,6th Floor,Suite 200, Baltimore, MD 21201 USA
关键词
Fluid resuscitation; Crystalloid; Colloid; Fluid responsiveness; Fluid challenge; Fluid overload; Acute kidney injury; Hyperchloremia; GOAL-DIRECTED RESUSCITATION; CENTRAL VENOUS-PRESSURE; IN-HOSPITAL MORTALITY; SEPTIC SHOCK; CRITICALLY-ILL; ENDOTHELIAL GLYCOCALYX; DIASTOLIC DYSFUNCTION; HYDROXYETHYL STARCH; 0.9-PERCENT SALINE; OXYGEN-SATURATION;
D O I
10.1016/j.emc.2016.08.001
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Since its original description in 1832, fluid resuscitation has become the cornerstone of early and aggressive treatment of severe sepsis and septic shock. However, questions remain about optimal fluid composition, dose, and rate of administration for critically ill patients. This article reviews pertinent physiology of the circulatory system, pathogenesis of septic shock, and phases of sepsis resuscitation, and then focuses on the type, rate, and amount of fluid administration for severe sepsis and septic shock, so providers can choose the right fluid, for the right patient, at the right time.
引用
收藏
页码:59 / 74
页数:16
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