Principles of intravenous fluid therapy for handouts教材课程.ppt

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2018-05-24 发布于天津
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Principles of intravenous fluid therapy for handouts教材课程.ppt

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Principles of intravenous fluid therapy;On the floor lay a girl of slender make and juvenile height, but with the face of a superannuated hag... The colour of her countenance was that of lead - a silver blue, ghastly tint; her eyes were sunk deep into sockets, as though they had been driven an inch behind their natural position; her mouth was squared; her features flattened; her eyelids black; her fingers shrunk, bent, and inky in their hue… In short, Sir, that face and form I can never forget, were I to live beyond the period of mans natural age.; ; ; ;Current controversies in fluid therapy;Assessment of volume status;Assessment of volume status;Assessment of volume status;Assessment of volume status;Trauma;Trauma;Peri-operative;Peri-operative;Peri-operative;However…;Early Goal-Directed Therapy in the Treatment of Severe Sepsis and Septic ShockEmanuel Rivers, M.D., M.P.H., Bryant Nguyen, M.D., Suzanne Havstad, M.A., Julie Ressler, B.S., Alexandria Muzzin, B.S., Bernhard Knoblich, M.D., Edward Peterson, Ph.D., Michael Tomlanovich, M.D., for the Early Goal-Directed Therapy Collaborative Group;Rivers E et al. Early Goal-Directed Therapy in the Treatment of Severe Sepsis and Septic Shock. NEJM 2001; 345: 1368-77;Protocol group;;Treatment given;The take-home message!;FACTT Study;FACTT;FACTT;FACTT;Now for which fluid…;What is the choice?;Fluid distribution;Roberts I, Alderson P, Bunn F, P?Chinnock, K?Ker and Schierhout G. Colloids versus crystalloids for fluid resuscitation in critically ill patients (Cochrane Review). The Cochrane Library, Issue 4, August 24th, 2004;Albumin vs. crystalloid;HES vs. crystalloid;Gelatin vs. crystalloid;Dextran vs. crystalloid;“There is no evidence from randomised controlled trials that resuscitation with colloids reduces the risk of death compared to crystalloids in patients with trauma, burns and following surgery. As colloids are not associated with an improvement in survival, and as they are more expensive than crystalloids, it is ha