| Perioperative Medicine | |
| Dose and type of crystalloid fluid therapy in adult hospitalized patients | |
| AB Johan Groeneveld1  Can Ince1  Annemieke Smorenberg1  | |
| [1] Department of Intensive Care, Erasmus Medical Centre, ‘s-Gravendijkwal 230, 3015, CE, Rotterdam, The Netherlands | |
| 关键词: Hypertonic saline; Ringer’s lactate; Normal saline; Fluid resuscitation; Hypovolemia; Shock; | |
| Others : 816376 DOI : 10.1186/2047-0525-2-17 |
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| received in 2012-12-04, accepted in 2013-07-04, 发布年份 2013 | |
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【 摘 要 】
Objective
In this narrative review, an overview is given of the pros and cons of various crystalloid fluids used for infusion during initial resuscitation or maintenance phases in adult hospitalized patients. Special emphasis is given on dose, composition of fluids, presence of buffers (in balanced solutions) and electrolytes, according to recent literature. We also review the use of hypertonic solutions.
Methods
We extracted relevant clinical literature in English specifically examining patient-oriented outcomes related to fluid volume and type.
Results
A restrictive fluid therapy prevents complications seen with liberal, large-volume therapy, even though restrictive fluid loading with crystalloids may not demonstrate large hemodynamic effects in surgical or septic patients. Hypertonic solutions may serve the purpose of small volume resuscitation but carry the disadvantage of hypernatremia. Hypotonic solutions are contraindicated in (impending) cerebral edema, whereas hypertonic solutions are probably more helpful in ameliorating than in preventing this condition and improving outcome. Balanced solutions offer a better approach for plasma composition than unbalanced ones, and the evidence for benefits in patient morbidity and mortality is increasing, particularly by helping to prevent acute kidney injury.
Conclusions
Isotonic and hypertonic crystalloid fluids are the fluids of choice for resuscitation from hypovolemia and shock. The evidence that balanced solutions are superior to unbalanced ones is increasing. Hypertonic saline is effective in mannitol-refractory intracranial hypertension, whereas hypotonic solutions are contraindicated in this condition.
【 授权许可】
2013 Smorenberg et al.; licensee BioMed Central Ltd.
【 预 览 】
| Files | Size | Format | View |
|---|---|---|---|
| 20140710194431774.pdf | 287KB |
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