Perioperative fluid and volume management physiological basis, tools and strategies 英文参考文献.docVIP

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Perioperative fluid and volume management physiological basis, tools and strategies 英文参考文献.doc

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Perioperative fluid and volume management physiological basis, tools and strategies 英文参考文献

Strundenetal.AnnalsofIntensiveCare2011,1:2 /content/1/1/2 REVIEW OpenAccess Perioperativefluidandvolumemanagement: physiologicalbasis,toolsandstrategies MikeSStrunden1,2*,KaiHeckel1,2,AlwinEGoetz1,2,DanielAReuter1,2 Abstract Fluidandvolumetherapyisanimportantcornerstoneoftreatingcriticallyillpatientsintheintensivecareunitand intheoperatingroom.Newfindingsconcerningthevascularbarrier,itsphysiologicalfunctions,anditsrole regardingvascularleakagehaveleadtoanewviewoffluidandvolumeadministration.Avoidinghypervolemia,as wellashypovolemia,playsapivotalrolewhentreatingpatientsbothperioperativelyandintheintensivecareunit. Thevariousstudiescomparingrestrictivevs.liberalfluidandvolumemanagementarenotdirectlycomparable,do notdiffer(inmostinstances)betweencolloidandcrystalloidadministration,andmostlydonotrefertothe vascularbarrier’sphysiologicbasis.Inaddition,veryfewstudieshaveanalyzedtheuseofadvancedhemodynamic monitoringforvolumemanagement. Thisarticlesummarizesthecurrentliteratureontherelevantphysiologyoftheendothelialsurfacelayer,discusses fluidshifting,reviewsavailableresearchonfluidmanagementstrategiesandthecommonlyusedfluids,and identifiessuitablevariablesforhemodynamicmonitoringandtheirgoal-directeduse. Introduction perioperative volume therapy. However, all of those There is increasing evidence that fluid management threeaspectscannotbeseparatedfromeachotherwhen influencespatient’soutcomeaswellincriticalillness,as definingrationalstrategiesforfluidmanagement.Thus, during and after major surgery. Hence, the numerous this review article summarizes the knowledge of the differentaspectscontributingtofluidmanagementhave functionanddysfunctionoftheendothelialvascularbar- been in the focus of both basic and clinical research rier,ontheeffectofdifferentintravenousfluidsandon during the past years. Basically three questions are theopportunitiesofhemodynamicmonitoringtoenable intrinsically tied tofluid administration perioperatively drawingconclusionsforrationalc