Fluid therapy in shock
Fluid therapy in shock
复制标题
休克的液体治疗
DOI：
10.1007/bf01655332
复制
发表时间：
1983
影响因子：
2.6
通讯作者：
L. Thorén
中科院分区：
文献类型：
--
作者：
G. Arturson;L. Thorén
在休克治疗的初始液体治疗中必须考虑三个主要因素：（a）血容量不足;（B）氧转运能力;和（c）水和电解质的代谢需求。为了计算用于代偿性血量损失的初始体积，可以将患者分类为：A组-即将或轻微损失[假定损失总血量（TBV）的20%]; B组-中度休克（TBV的20-35%）;和C组-重度休克（TBV的>35%）。这些组最初分别用20%、30%和50%的TBV替代治疗。通过持续观察进行个体化治疗，并根据需要进行改变。晶体和胶体溶液的相对优点和适应症的使用进行了概述。必须保证氧气输送到组织。随着血细胞比容水平的降低，血液的流动特性改善，携氧能力降低;血细胞比容阅读约为30或略高于30就足够了。在确定代谢需求时，必须考虑3个因素：水和电解质的生理每日需求;增加的肾外液体损失;以及创伤中细胞外体积的减少。
Three principal factors must be considered in initial fluid therapy in the treatment of shock: (a) blood volume deficit; (b) oxygen transport capacity; and (c) metabolic requirement of water and electrolytes. For the calculation of the initial volume to be used in compensatory blood volume loss, patients may be categorized thusly: group A—impending or slight loss [assumed loss of 20% of total blood volume (TBV)]; group B—moderate shock (20–35% of TBV); and group C—severe shock (>35% of TBV). These groups are treated initially with 20%, 30%, and 50% of TBV replacement, respectively. Treatment is individualized by continuous observation and changes are made as required. The relative merits and indications for use of crystalloid and colloid solutions are outlined. Oxygen delivery to the tissues must be guaranteed. The flow properties of the blood improve and the oxygen carrying capacity decreases with reducing hematocrit levels; a hematocrit reading of about 30 or slightly above is adequate. In determining the metabolic requirements, 3 factors must be considered: the physiologic daily requirement of water and electrolytes; the increased extrarenal fluid losses; and the reduction of the extracellular volume in trauma.