第3章：感染性休克过度复苏？限制复苏？.pdf

Acta Anaesthesiol Scand 2009; 53: 843–851 r 2009 The Authors Printed in Singapore. All rights reserved Journal compilation r 2009 The Acta Anaesthesiologica Scandinavica Foundation ACTA ANAESTHESIOLOGICA SCANDINAVICA doi: 10.1111/j.1399-6576.2009.02029.x Review Article ‘Liberal’ vs. ‘restrictive’ perioperative fluid therapy – a critical assessment of the evidence M. BUNDGAARD-NIELSEN1,2, N. H. SECHER2 and H. KEHLET1 1Section of Surgical Pathophysiology, and 2Department of Anaesthesia, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark Background: Several studies have assessed the effect of a regimen whereas two studies found no difference and two ‘liberal’ vs. a ‘restrictive’ perioperative fluid regimen on studies found differences in the selected outcome para- post-operative outcome. The literature was reviewed in meters. order to provide recommendations regarding periopera- Conclusion: Liberal vs. restrictive fixed-volume regimens tive fluid regimens. are not well defined in the literature regarding the defini- Methods: A PubMed search identified randomized clinical tion, methodology and results, and lack the use of or trials and cited studies, comparing two different fixed fluid information on evidence-based standardized periopera- volumes on post-operative clinical outcome in major surgery. tive care-principles (fast-track surgery), thereby preclud- Studies were assessed for the type of